Personal Information
Emergency Contact
Surgery Preferences
SMOKING/ALCOHOL/DRUGS
MEDICAL HISTORY
CHECKLIST OF PREVIOUS ILLNESSES
If you feel there are any further details which may help us in providing you with they appropriate treatment/surgery information please specify below.
Recent copies of x-rays, scans, diagnosis reports, medical reports will help provide a more accurate estimate & medical opinion.
Med Tourism Co LLC
(www.medicaltourismco.com) connects patients to one of the best hospitals in the world. Med Tourism Co LLC does not provide advice on medical treatments nor makes claims or guarantees on the outcome of any medical treatment or surgery. Before making any medical related decision you must thoroughly discuss & seek advice from a qualified medical professional.
The information I have provided is true and accurate and to the best of my knowledge.