International Patients form
If you are looking for a certain treatment and would like us to assist you with choosing your medical center and helping with any of the arrangements that you need, please fill out the form below and we will revert to you with a Cost Estimate accordingly.
Date of Birth
If outside UAE, please mention the country code and area code (eg. +971 50 123 4567)
Country of Residence
What kind of treatment are you interested in?
Any specific country you would like to be treated in? If yes, please mention.
Would you like us to help you with any of the following? Please select.
Applying for a medical visa
Booking your flight
Request a specially equipped vehicle at the airport
Car rental service
Touristic trips and tours
Recreation trips for the elderly
If you have any special instructions, please mention in the box provided. Thank you.
Do Not Fill This Out