Please provide correct Contact number and Email Id as we will revert to confirm.
Patient Type*
Self Paying Patient
Insurance - Patient
Do you want to stay ahead from the rest ?
Yes
No
Extra AED100 is applicable*
Choose *Fast Track Clinic for :
- No waiting time
- One-on-one assistance
- Free Refreshment
Do you want Teleconsultation ?
Yes
No
Branch *
Department
Clinic Name*
Appointment Date
Appointment Time*