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Welcome to Hayakom's Medical and Tourism Services Form

Welcome to Hayakom's Medical and Tourism Services Form

Please set aside approximately 5 minutes to complete this form & have them submitted at least two business days prior to your desired first appointment date.
9Questions
  • 1
    Names and track records of doctors will be provided before confirming your trip
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  • 2
    Relevant medical documents or reports to assist our medical consultants. Your health information is confidential and will be handled with the utmost care.
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    Max. file size: 10.6MB
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  • 3
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  • 4
    These locations are popular for wellness tourism, offering natural remedies and therapeutic environments. Choose your destination .
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  • 5
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  • 6
    Total number of travelers
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  • 7
    Total Number of Travelers
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    • More
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  • 10
    Desired Destinations : Our team will check the availability and timing for your request and get back to you soon. If it's available, we'll share the pricing details with you.
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  • 11
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  • 13
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    Pick a Date
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  • 14
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    Pick a Date
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  • 15

    Oops! There is an error with the dates. Please adjust the Check-in date to be after the Check-out date.

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  • 16
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  • 18
    Please specify any special requirements for your accommodation, such as bed types, view preferences, amenities, accessibility needs, proximity to certain locations, and room features.
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  • 19
    Please Select
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    • Bank Transfer
    • Visa
    • Credit Card
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  • 20
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