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As with any medical surgery—whether surgical or non-surgical—prior to undergoing plastic surgery Turkey or hair transplantation, it’s essential to gather basic information about your health. Medical background check is a form designed to thoroughly assess your unique medical condition—and to assure that your procedure is conducted with the ultimate in safety, comfort and effectiveness. Our doctors are trained in the latest techniques and state-of-the-art innovations in the field of plastic surgery and hair transplantation.

    First Name (required)

    Last Name (required)

    Date of Birth (required) day/month/year

    Your Email (required)

    Home Address (required)

    Do you take Allergies medication? (required)

    YesNo

    Have you had any infectious diseases or porter of a viral infection?
    ( HBsAg, HIV, HCV, etc) (required)

    YesNo

    Do you take Anaemia medication? (required)

    YesNo

    Do you take Asthma medication? (required)

    YesNo

    Do you take Birth control - The pill? (required)

    YesNo

    Please indicate your Blood pressure level (required)

    HighNormalLow

    Do you have Deep Vein Thrombosis/ Blood Clots? (required)

    YesNo

    Do you use Depression medication? (required)

    YesNo

    Do you have Diabetes? (required)

    YesNo

    Please describe Current and prescribed Medication you are taking

    Past Medical History that needs mention

    Do you drink or smoke?

    How many cigarettes do you smoke per day?

    Have you or your family ever had difficulties with General Anaesthetic?

    YesNo

    Do you have any known heart problems?

    YesNo

    Have you ever been jaundiced?

    YesNo

    Are you able to carry out physical activities?

    YesNo

    Have you had any previous surgery ? If so for what operation and when ?

    YesNo

    Do you wish to mention anything special?

    Please read terms and conditions Yes

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