Service Details – Choose Your Desired Procedure

Select the cosmetic treatment you're interested in. This helps us prepare the best package tailored to your needs.

Hair Transplantation

Dental Implants

Rhinoplasty

What's your name?

We need your full name to personalize your experience and communication.

Male Female

First name

Last Name

How can we reach you?

We’ll use this to contact you and confirm your treatment plan.

E-Mail Address

Password

Phone Number

Please enter a valid phone number including the country code (e.g., +49 for Germany)

Nationality – Your Country of Citizenship

Let us know your nationality. This helps us check visa requirements and plan your travel smoothly

What language do you prefer?

We’ll match you with a coordinator who speaks your language.

Job – Your Current Occupation

Tell us about your current job. This information is important to verify your eligibility for credit and to ensure smooth planning for your treatment journey.

When Would You Like the Treatment to Take Place?

Please let us know your preferred timeline for the treatment. This helps us prepare the best possible plan for your journey.

As soon as possible

Within the next 1 months

Within the next 3 months

Within the next 12 months

Do you have any major medical conditions?

Please let us know if you have any existing health conditions. This information helps our medical team prepare the safest and most suitable plan for your treatment.

Diabetes

High blood pressure

Heart disease

Lung problems (e.g., asthma, COPD)

Blood clotting disorder

Thyroid disorder

Autoimmune disease

None of the above

Do you have any allergies (e.g., anesthesia, latex, medications)

Please let us know if you have any known allergies. This is essential for your safety during the treatment process.

Yes

No

Not sure

Have you had any previous surgeries (cosmetic or medical)?

Please let us know if you have any known allergies. This is essential for your safety during the treatment process.

Yes — cosmetic

Yes — non-cosmetic

No

Have you ever had complications with anesthesia?

Please let us know if you have ever experienced any adverse reactions or complications during anesthesia in previous medical or dental procedures. This helps us take necessary precautions to ensure your safety during your treatment.

Yes

No