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Phone
+82 10 2996 6373
Keindahan Abadi &
PERAWATAN TERPERCAYA
Tur Bedah Plastik Khusus VIP dengan Korea Medi-Glam
KONSULTASI GRATIS
KOREA MEDI-GLAM
ABOUT
Who We Are
Why Choose Us
PORCEDURES
Facial Procedures
Body Contouring
Breast Augmentation
Hair Transplant
Skin Treatment
Vision Correction
GUIDANCE
Prior to Visiting Korea
Online Payment & Reservation
After Arrival
VAT Refund
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Informasi Pribadi
First Name
Last Name
Date of Birth
Gender
Nationality
Country of Residence
Country Code
Phone Number
Email
Your Concern
Riwayat Medis dan Perawatan
Have you had any previous surgeries? (If none, write "None"). Ex. Date (YYYY/MM) - procedure & details
Have you had any non-surgical treatments (ex. filler, botox, threads) ? (If none, write "None"). Ex. Date (YYYY/MM) - treatment & details
Medical History: (If none, write "None"). Ex. Condition - Date of Diagnosis (YYYY/MM) - Symptoms
Current Medications: (If none, write "None"). Ex. Start date (YYYY/MM) - Medication name - Dosage - Frequency - Purpose
Prosedur yang Diinginkan
Your Major Concern & What you Don't Like About it
Describe the results you’d like to achieve
Preferensi Kontak
Metode Kontak Pilihan
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Email
KakaoTalk
Other
Estimated Budget (Optional but helpful ): USD / KRW
Pemeriksaan Kondisi Kesehatan
Apakah Anda pernah atau sedang mengalami salah satu dari hal berikut ini? (Centang jika berlaku)
Hipertensi
Penyakit jantung
Diabetes
Gangguan hormonal
Penyakit autoimun
HIV
Other (please specify)
Are you currently undergoing any medical treatment? If yes, specify
Estimated dates for your trip to Korea: If already booked, please provide details
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