Please complete the following form for your holiday and treatments. Please give as much information as possible in all cases, especially your health and medical history.

All people having surgery is required to fill in the following forms. If you are travelling with another who is having surgery, please ensure that you forward this form to them to fill in.

All bookings must be accompanied by payment for accommodation, which can be paid by credit card or direct transfer. Payment for all surgery and dentistry treatments is payable direct to the hospital after the consultation with the surgeon, when you are happy and agree to go ahead.

IMPORTANT! Please read carefully:
Payment for your surgery has to be made in Cash or Credit Card. If you plan to bring cash (in the form of traveler's cheques), please inform your customer service manager to assist you - you will be taken to the nearest bank to cash them. If you are doing bank transfers, the money has to be cleared 7 days before your surgery day. If your payment is not available on surgery day, your surgery will be cancelled or postponed. Please note we do not accept personal cheques.