Best Health Service in a Turkey

Fill in your personal information completely.

Name Surname

Birth Date

Phone

Address

Height

Weight

Smoke

Drink

Recreational Drugs

Do you Exercise

Do you have Children

Are you Pregnant/Lactating

Write down the details of the surgeries you want.

What kind of surgical procedure(s) you are interested in?

What are the results you wish to achieve?

Mention your health details.

Do you have any medical conditions?

Are you taking any medication or herbal preparations? State name and dosage

Have you had any cosmetic surgery before? Please state year and procedures

Are you anemic or have a history of jaundice, hepatitis or HIV? If yes, please provide details.

Mussum ipsum cacilds, vidis litro abertis.

High Blood Pressure

Diabetes

Any bleeding problems

Any Skin problems

Allergies to medication

Food allergies

Do you take aspirin or blood thinners

Any reaction to local or general anaesthesia

Other medical problems, including communicable diseases? If Yes, please describe:

Is there anything your surgeon should be aware of for the management of your treatment and/or to make your stay at the hospital more comfortable?

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