Make An Appointment

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Patient's Particulars

Clinic

Patient Name *

Salutation

Nationality

Gender Male Female

Telephone No

Mobile No

Email *

Patient's Current Medical Conditions / Symptoms / Diagnosis

Preferred Appointment Period

Preferred Clinic / Doctor

Date

TimeSlot

Translators Required: (Please check with respective clinics if extra charges apply)

Remarks

By checking this box, I consent to the collection, use, disclosure and processing of my Personal Data by the Far East Organization stable of companies/entities (“FEO Group”) for the purposes of processing, communicating and responding to my enquiry, requests, feedback, comments and/or complaints, and for the purposes set out in this form and in Far East Organization’s Personal Data Protection Policy, which I have carefully read.

By MRT	:	Alight at Orchard MRT Station NS22
By Bus	:	Bus services available are 5, 54, 124, 128, 143, 162, 162M, 167, 171, 700, 700A, NR1, NR2 and NR3
By Car or Taxi	:	Parking is available at the basement of Pacific Plaza. Entrance via Claymore Hill.