Inquiy Form

If you want to inquire about a procedure or have a general question, please fill out the inquiry form below. Filling out this inquiry form is the first of three simple steps on your way to achieving your beauty desires:

 

  1. 1.Complete inquiry form
  2. 2.Complete medical questionnaire form
  3. 3.Complete booking form

* Required fields.

First Name*:

Last Name*:

E-mail*:

Telephone:

Mobile:
Hygeia Healthcare can call me

Address*:

Postal Code*:

City*:
State/Province:
Country*:
 
When are you planning to come?
 
What are you interested in?
 
Orthopedic Surgery Heart Surgeries

Coronary Angioplasty (Baloon)
Angiography
Heart Bypass (Coronary Artery Bypass Grafting)
Heart Valve Replacement





   

Brain Surgery
Cancer Treatment
Glaucoma
Stem Cell
Kidney Transplant

 


Liver Transplant
Bone Marrow Transplant
Hysterectomy (Removal of Uterus)

Infertility Treatment

 
Questions or Comments:
 
What is your main reason for seeking treatment abroad?
 
How did you hear about us?
 
Sign up for Hygeia Healthcare Newsletter
 
 
Contact Details:
Hygeia Healthcare
1st Flr., Benjamas Building
330, 332 Charansanitwong Rd., Bang-O
Bangplad, Bangkok 10700 Thailand

Phone: +66 2 879 1575
Phone (From the UK): (+44) 020 8133 8346
Phone (From Denmark): (+45) 36 98 0111
Phone (From USA): (+1) (323) 319 5865
Phone (From Australia): (+61) (02) 8006 2040
Phone (From New Zealand): (+64) 04 889 0031
Fax: +66 2 879 1579


E-mail: bookings@destinationhospital.com