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Plastic Surgery Phuket

MQ

Step 1 of 5 - Personal Details

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  • The first and most essential step to a successful surgery is for doctor to learn as much about patient as possible. This Medical Questionnaire helps our plastic surgeons determine if you are medically qualified for your surgery.

    Remember there is no obligation once an estimate is created.
  • As in passport
  • As in passport
  • (Month and Year)
  • (Month and Year)




  • After you fill out the Questionnaire, a plastic surgeon from your preferred hospital will carefully review your case and prepare an initial evaluation, including a price quote for procedure(s) of your choice.
  • example: liposuction, tummytuck, etc.
  • Can be approximate


  • Beauty Med representative will share the doctor’s preliminary evaluation and price quote with you, answer any questions you may have, and schedule a surgery date.

    Beauty Med will help arrange your trip to Thailand, including taking care of all hospital administrative and patient admission procedures, airport pick up, hospital/hotel transfers, and more — absolutely free for you.



  • Information you provide in this Questionnaire will become part of your private medical record, used only by the hospital where you have your operation.



  • Taking & submitting photographs:

    To allow a cosmetic surgeon to make the most comprehensive assessment of your case and provide the best possible recommendation for your surgery, please do your best to take your photographs in the following format.

    • Use solid background
    • Take one frontal photo of your chest, body or face, centered and looking forward
    • Take at least one, preferably two profile (side view) photos, at either right or left angle 
    • Take one photo of your back, if needed

            

    Your photographs are kept in strict confidence and only shared with doctors who are assigned to handle your medical procedure.



  • Drop files here or
    Accepted file types: jpg, jpeg, gif, png, pdf, bmp, webp.


  • This field is for validation purposes and should be left unchanged.
Plastic Surgery Phuket

Beauty Med (Thailand) Co., Ltd | Thailand Office +(66) 2 653 3880 | Australia Office +(02) 800 500 56

Floor 17 unit 1708, One Pacific Place, 140 Sukhumvit Rd. Klongtoey Bangkok 10110, Thailand.