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Please contact us for any inquiries related to your appointment.
Phone : 82-32-1600-8291
(*) Necessary Input Information

Patient Information
*Name
*Date Of Birth
*Gender
*Nationality
*E-mail @
*Cell Phone No.
Home Phone No.  
Office Phone No.
*Address(Korea/Home)
Appointment Details
*Covid-19 Test
Alien Register No.
*Passport No.
*Date of appointment
*Date of departure
Describe history of medication intake
Describe history of surgery, medical treatment

Please fill out the form attached.

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