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Media
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About
Partners
Consulting
Influencers
Press
medical and cosmetic procedures
Plastic Surgery
Body Contouring
Breast Surgery
Anti-Aging
Nose Surgery
Eye
Face Contouring
Skin
Dental
Hair Tranplant
Women’s Surgery
General Hospital
Stem Cells
Special Procedures
Services
Concierge
Experience
Tour Liaison
How it works
Reviews
Enquiry
FAQ
Quick Consultation
Contact
Media
Blog
Consulta Rápida
Personal Details
Full name (as appears on your passport) / Nationality
*
Phone
*
Email Address
*
Messenger & Chatting ID/WhatsApp/Kakao
*
Messenger Channel - ID/Number i.e. Skype-user123
Date of Birth (YYYY/MM/DD) / Gender
City & Country of Residence
*
Preferred Language
Medical Trip Information
Do You Need A Visa?
*
Yes
No
Desired Surgery/Treatment
*
Please be specific, ex) Nose surgery with alar reduction, Eyelid surgery with Epicanthoplasty..) If Liposuction is your desired surgery, please additionally write height & weight
What is Your Estimated Budget For Desired Surgery/Treatment?
*
USD
Have You Booked A Flight?
*
Yes
No
Flight Information
*
Please Write "Undecided" if not booked yet
Arrival date in Korea (YYYY/MM/DD)
*
Departure Date From Korea (YYYY/MM/DD)
*
Have You Contacted Clinics or Other Agencies ? If so, which ones?
Do You Need Help Booking Accomodation?
*
Yes
No
What Is Your Hotel Budget ?
Desired date / time of consultation (YYYY/MM/DD)
*
Desired date of surgery/treatment (YYYY/MM/DD)
*
Any major medical history / allergies (medical/daily)
*
Previous plastic surgeries (If any, when)?
*
Medications Currently Used (If any)
*
Additional Comments
Pictures of Affected Area(s)
In Order To Get An Accurate Quote, it's best to submit pictures if it is applicable. Please note that these pictures are solely for the purpose of consultation and to get a more accurate quote. (Each picture should show the whole face or body)
Frontal
45 Degree To The Left
Left Side
45 Degree To The Right
Right Side
Nostrils
For Rhinoplasty, Please cock your head up, showing nostrils
Affected Body Part
How Did you Hear About Us?
*
Google
Facebook
Instagram
YouTube
Referral From A Friend
Influencer(Add Name of Influencer and Channel in "other"
Consultant
Agreement
Agree
All Information Submitted Via This Form is For Private Use only. It is for the sole purpose of getting a quote for your surgery/treatment. We will not rent, sell or utilize your Information in any way to third parties other than our clinics. By Checking the Box and clicking Submit; you acknowledge this.
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