Please have your photographs ready to be attached prior to filling out the Online Assessment Form.

  • Personal Information
  • Emergency Contact
  • Destination & Treatment
  • Cosmetic Assessment
  • Upload Required Photos

Personal Information



Emergency Contact

Contact Information

Emergency Contact (Not travelling with you)



Destination & Treatment

Clinic & Travel Information



Cosmetic Assessment

Habits



Upload Required Photos

Photographs Required
PHOTOS ARE REQUIRED to secure a surgical recommendation. Make sure you have looked at the correct examples which are found here on:
PROCEDURES

FACE & EYE
NOSE
EAR

TUMMY
BREAST
ARMS

IMAGE LOADING: If you are having problems uploading your images onto this form, submit the form and email images separately to: info@medicaltravel.com.au


Pin It on Pinterest