Treatment Information, Opinions & Quote Form

Please fill out this patient intake form in order for the My Seoul Secret team to assist you with your journey and treatment plan in Seoul.

Receiving a virtual or (email) consultation is free, and there is no obligation for you to have procedures at the clinics who respond back to your consultation request. These consultations are designed for educational purposes to help you understand available treatment options as a medical tourist and should not be considered medical advice and is not a substitute for consultation with a qualified medical professional.

  • Which country passport do you hold?
  • If you don't know the exact date yet just choose and approximate date.
  • Have you had surgery before? Do have a medical condition your doctor should be aware about. Please be as detailed as possible.
  • Please tell us what you would like the doctor to know and what your current concerns are about your appearance?
  • Add a new row
  • Drop files here or
    Please add photos such as front, side and 45 degree angle.
    You cannot submit this form if you do not agree. If you do not agree, please exit this webpage.
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