Appointments

Health Checkup Appointment

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Patient Information

Patient Information
First Name Last Name
Date of Birth
Gender
Nationality
E-mail Phone Number

Appointment Details

Preventative Health Screening Information
Preferred check-up program
Preferred Date
Medication Intake (0/300 C​haracter)
History of disease (0/300 C​haracter)
Hotel Address
Comments (0/300 C​haracter)

If you have private insurance, you can charge the fee to your insurance company personally.