Health Abroad / Medical Procedures at Half the Cost

Pricing for Our Service $2,400.00 per person / second person $3,499.00 based on double occupancy.

This price includes 10 nights accommodation in Bangkok plus the services listed on the page one of the brochure. Additional nights and tours outside Bangkok are available and priced accordingly.

This includes the services of an American guide while in Thailand.

Patient's Name :
Patient's Address :
City :	State: Zip:
Dates in Thailand :
Passport Number :
Airline Flight Number :
E-Mail :
Phone :
Procedure :
Name of Doctor :
Name of Hospital :
Total Time needed before Surgery :
Amount of Recovery Time :
Contact Person in US :

Please fill in the comments section describing any special dietary needs, or other special needs ie. wheelchair etc. and what would you like to do or see while in Thailand.

Include names of: People in your party Their addresses Their phone numbers Their ages Their passport numbers Their flight numbers Their airline (to and return)