Appointment Form
When you are ready to make your appointment, please supply the following information (submit the form below). If you think it would be helpful for the doctor, please email photographs to
For complete details, including prices, of the procedure(s) in which you are interested - dental, cosmetic, eye or elective surgery, please supply your contact information and a personalized quote will be emailed to you within 24 hours, a little longer if we need to do more research for your procedure. (Telephone number is optional. We will call only if you request it.)
If you have not yet booked your accommodation for your stay in Thailand, and you would
like to take advantage of our free recommendation and booking service (the hospitals have
some great corporate rates for their patients) please apply on line on the accommodations page.
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