Medical Intake form

Would you like to start your treatment with an online medical consultation or would you prefer to schedule an appointment to visit Egypt?Choose the option that suits you best to easily start your treatment with the top dentists in Egypt.

I would like to start with an online medical consultation.

I would like to schedule an appointment to visit Egypt.

I need a doctor with a portable device to visit me upon my arrival in Egypt.

I’m not sure yet – I need help choosing the best option.

What services are you interested in? (Select from the list)The doctors' names and records will be provided before confirming your trip.

Dental Implants, Surgery, and Restoration

Cosmetic Dentistry (Hollywood Smile / Veneers / Orthodontics)

Dental Treatments (Cosmetic Fillings / Root Canal Therapy / Full Restoration)

Laser Teeth Whitening and Gum Cleaning

Pediatric Dentistry with Comfortable and Safe Sedation (including General Anesthesia for Complex Cases)

Other

Upload any previous dental X-rays or medical reports (optional)Relevant documents or medical reports to assist our medical consultants. Your health information is confidential and will be handled with the utmost care.

Drag and drop files here

Select files to upload

Are you interested in exploring natural treatments and healing environments in Egypt?Discover relaxation, wellness retreats, and natural therapies during your stay.

YesNo

Healing Destinations in Egypt: Natural Treatments and Therapeutic EnvironmentsThese sites are famous for wellness tourism, offering natural treatments and healing environments. Choose your destination.

Siwa Oasis: Famous for its hot springs, healing mud baths, and salt lakes offering natural wellness experiences.

Marsa Alam: Known for its pristine natural hot springs ideal for relaxation and therapeutic benefits.

Aswan: Renowned for its dry, clean climate — highly beneficial for respiratory conditions and rheumatism patients.

Safaga: Globally recognized for its black sand beaches and mineral-rich waters that help treat skin and joint disorders.

Ain Sokhna: Offers warm mineral springs known for promoting relaxation and natural healing.

Bahariya Oasis: Home to therapeutic hot springs providing unique healing properties.

Fayoum: Known for its medicinal springs and scenic lakes, combining wellness with nature.

New Valley (El Wadi El Gedid): Offers therapeutic hot springs and a favorable healing climate.

El Quseir: Distinguished by its black sand beaches with proven therapeutic effects.

Other

"Who will be traveling?"

Myself

Couple

Family

Are you also interested in tourism services? If yes, please select your preferred activities and we will customize the trip according to your needs.* This field is required.

YesNo

Activities you would like to add to your tripPreferred destinations: Our team will check availability and scheduling for your request and will contact you shortly. If available, we will share the pricing details with you.

Safari Trips — Desert 4x4 adventure (5+)

Shows / Theater — Live performances (10+)

Unique Tours — Custom sightseeing tours (10+)

Biking / Buggy — Ride near pyramids (12+)

Camel Rides — Camel tour by pyramids (5+)

Nile Felucca — Relaxing boat ride (All ages)

Khan El Khalili — Traditional market visit (All ages)

Wadi Degla Climbing — Outdoor rock climbing (15+)

Horse Riding — Desert horseback ride (10+)

Nile Kayaking — Paddle the Nile (12+)

Al-Azhar Park Walk — Garden walk & birdwatching (All ages)

Malls Visit — Modern shopping tour (All ages)

Zoo / Africano — Family zoo visit (All ages)

Wellness & Spa — Relaxation packages (Adults)

Underwater Adventures — Diving/snorkeling (10+)

Pyramid Skydiving — Tandem skydive (18+)

Farm-to-Table — Fresh food tasting (All ages)

Nightlife — Evening entertainment (Adults)

Music/Dance Lessons — Cultural classes (10+)

Souvenirs — Shopping for gifts (All ages)

Sandboarding — Dune surfing (8+)

Cairo Tower — City views (All ages)

Street Food Tour — Downtown tasting (10+)

Nilometer — Historic Nile site (All ages)

Opera House — Elegant concerts (10+)

Al-Azhar Park — Garden leisure (All ages)

Naguib Mahfouz Café — Literary café (12+)

Mohamed Ali Palace — Royal palace tour (All ages)

Masa’a Misr — Nile walkway (All ages)

Cairo City Tour — Full city tour (All ages)

The services you need during your tripAll the care and support you need — from arrival to departure.

Flight Tickets

Accommodation

Car Rental

Companion And Care Services (Driver, Nanny, Housekeeper, Elderly Or Special Needs Care)

Limousine Transfers To And From The Airport

VIP & Luxury Services

Real Estate And Investment Consultations

Event Coordinators

Dining Recommendations

Local Tips And Information

London Taxi

Other

Hotel / Accommodation Class* This field is required.Accommodation that matches your expectations

Luxury Hotels (Five-Star and Other Luxury Properties)

First-Class Hotels and Inns (Four-Star and Equivalent Properties)

Villa Rentals (Private Rental Properties with Home-Like Amenities)

Apartment Rentals (Private Rental Properties with Home-Like Amenities)

Tourist-Class Hotels and Inns (Three-Star and Equivalent Properties)

Basic Hotels (May Feature Shared Hallway Bathrooms)

Number of Rooms* This field is required.Specify the number of rooms for your stay

Preferred daily rental budget (USD)Optional: share your budget to receive the most suitable offers

$30 - $70 USD

$75 - $150 USD

$155+ USD

أخري

Are there any specific requirements for your stay?"Please specify any special requirements for your stay, such as bed types, view preferences, amenities, proximity to certain locations, and room features."

When do you plan to arrive in Egypt ?Please specify your expected arrival date so we can coordinate your medical and tourism bookings perfectly.

Date

Duration of StayLet us know the length of your stay to better arrange your experience.

Please leave your details below and press submit to start arranging your trip.Your information is securely stored and handled in full compliance with HIPAA privacy standards.

First Name

Last Name

Phone Number