*Name *GenderMaleFemale *Date of birth12345678910111212345678910111213141516171819202122232425262728293031 Residence: Address *Email *Telephone
Face:EyeNoseBone reductionChinForeheadLipNasolabial foldSubmalar triangleFaceliftCheek augmentationComposite facial surgeryScarDermabrasionOthers Breast:Breast augmentationBreast liftBreast reductionNippleAreolaBreast reconstructionAccessory breastGynecomastiaOthers Body:LiposuctionCalf reductionAbdominoplastyFat injectionHip augmentationGenital organ surgeryTranssexual surgeryOthers
Treatment item:BotoxHyaluronic acidRadiesseAquamidSculptraLipolysisOthers Treatment objective:RhytidectomySlim faceCalf reductionNasal bridge augmentationChin augmentationNasolabial foldCheek augmentationSubmalar triangle augmentationTemple augmentationInjection liftOthers Skin laser and phototherapy:Speckle removalMole removalScar removalWhiteningTighteningHair removalTattoo removalOthers
*Please elaborate the name or extent of the surgery you want to undergo, and we will provide sufficient time for your surgery.
*The photo you upload will enable the physician to confirm the extent and method of the surgery in advance and help preoperative preparations.
*Our staff reserves the right to adjust the time, and we will confirm the final time with you 3 days before the surgery by telephone or email Date of appointment Outpatient: Surgery: On the same day of consultation or Appointment time:Morning (10:00~12:00)Around noon (12:00~14:00)Afternoon (14:00~17:00)Evening (17:00~19:00)Night (19:00~22:00)
Deposit:NTD $20,000
*Your deposit paid online may be deducted from the surgery expenses. If you are unable to come to the clinic for surgery, please contact us to cancel or delay the surgery by telephone or email 1 week in advance, and we will save your deposit for the next surgery. However, if you cancel the appointment for the surgery on the day of surgery without reasonable cause, we will revoke your right of deposit saving or refunding.
Method of payment:Paypal
Supplementary notes
*Please leave your actual contact information, and our representative will contact you informing you of the receipt of the funds within 3 days. If you do not receive our response within 3 days, this indicates that your appointment procedures have not been completed. Please transmit your form or directly call us to inquire about the progress.
If you would like to make a down payment via PayPal, Click here!
