Renovated Me | Patient Information Form

Skip to content

Home
About Us
- How It Works
Treatments
Gallery
Contact

Better Health, Better Me

Enquire Now

Home
About Us
- How It Works
Treatments
Gallery
Contact

Better Health, Better Me

Renovated Me | Patient Information Form

RenovatedMe - Patient Information Form

Full Name

Email

Age

Gender

Height

Weight

Do you have any health issues?

Yes

No

If yes, please explain.

Do you take any type of medications on a daily basis?

Yes

No

If yes, please explain.

Do you have diabetes?

Yes

No

Do you have heart issues?

Yes

No

If yes, please explain.

Do you have joint pain?

Yes

No

Do you have any allergies?

Yes

No

Are you currently receiving any treatment for any health problems or have you received any treatments in the last 5 years?

Yes

No

If yes, please explain.

Have you had any type of chemotherapy treatment before?

Yes

No

ave you had any surgery previously?

Yes

No

If yes, please explain.

Have you had anaesthetics before?

Yes

No

If yes, had any problems? Please explain.

Is there any family history of health conditions, particularly those related to heart problems or cancer?

Yes

No

If yes, please explain.

Is there any family history of health conditions, particularly those related to heart problems or cancer?

Yes

No

What is your eating habits?

Have you tried any diets before?

Do you smoke?

Yes

No

If yes, how many?

Do you drink alcohol?

Yes

No

If yes, how much and how often?

Do you use any recreational or hallucinogenic drugs?

Yes

No

If yes, please explain.

Do you play any kind of sport or go to the gym?

Yes

No

Which birth control method do you use (if applicable)?

Emergency contact person and phone number

Home
About Us
Contact
How It Works
Terms & Conditions
Privacy Policy

Renovated Me is a UK company based in London. We provide medical tours to Turkey for Weight Loss Surgery, including: Gastric Bypass, Gastric Sleeve and Mini Bypass, Aesthetic and Cosmetic Surgery; Tummy Tuck, Breast Implant, Rhinoplasty, Mummy Makeover, Dental Implants and Hair Transplant. We facilitate high-quality healthcare for your needs, shortening waiting times and offering the best affordable prices.

RenovatedMe – Turkey Treatment Enquiry Form

Tell us a little bit about the treatment you are exploring in Turkey.

Please fill out this quick form with your treatment goals, and our medical coordinator will contact you shortly to discuss your personalised treatment plan, pricing, and travel arrangements.

RenovatedMe Medical Treatment Turkey Contact Form

Name

Email

Phone Number

Treatment Category

Message