DENTAL / SMILE DESIGN– Your Surgery Readiness Form

DENTAL / SMILE DESIGN – Your Surgery Readiness Form
Our Oceanscape Team is excited to guide you on your journey toward a brighter, healthier smile and more confident you.

This quick readiness form helps us understand where you are in your decision-making, what support you may need, and how we can connect you safely with one of our accredited Turkish surgeons.

We'll ask a few short questions about your goals, travel comfort, health background, and preferred timeline so we can prepare the right next steps for you.

It only takes a few minutes to complete.

Once submitted, you'll receive an invitation to book your 30minute Discovery Call with our Oceanscape team.

Your details are stored securely and protected under KVKK, GDPR, and NZ/AU Privacy Law. This form is confidential and used for assessment only. Completing it does not confirm a booking or guarantee medical approval.

Section A - Personal Details
Name*

First NameLast Name
Date of Birth DDMMYYYY*

DayMonthYear
Date
Email*
example@example.com
Mobile Number (+ country code)*

Country CodeArea CodePhone Number
Country of Residence
Photo of Passport Page

Cancelof

Section C - Health Information
Important Notice –

Your honesty helps us take the very best care of you.

Please share as much as you can about your health and wellbeing, including any mental health conditions or medications.

There’s no judgment at all — this information simply helps our surgeons and care team understand your full picture so they can plan safely and support you in the right way.

If something is missed or not disclosed, it can affect your eligibility or the treatment approach later on.

Oceanscape Group’s role is to keep you safe, and we may pause or adjust your facilitation if new medical details come to light that change your suitability for surgery.
Height (cm)*
Weight (kg)*
Do you smoke or vape?*

YesNo
Do you drink alcohol?*

RarelyRegularlyNo
Please list any known MEDICAL CONDITIONS (if any)*
Are you under specialist care?*

YesNo
Have you been told surgery may be risky?*

YesNo
Please list any PREVIOUS SURGERIES (if any)*
Please list any known ALLERGIES (if any)*
Please list ALL CURRENT MEDICATIONS (if any)*

Section E — KVKK, GDPR & Privacy Consent
Oceanscape Group Limited (New Zealand) and Oceanscape Group Türkiye Sağlık Turizmi Ltd. Şti. act as Joint Data Controllers for the purpose of preparing your treatment eligibility and quote.

We process your personal and health information for:

Eligibility assessment and preliminary surgeon review
Quotation preparation and travel coordination
Compliance with Türkiye’s International Health Tourism regulations and NZ/AU privacy laws

Your information is stored on encrypted systems in Türkiye and New Zealand, and may be securely transferred between New Zealand, Australia and Türkiye as part of your medical coordination process.

All data handling complies with KVKK (Law No. 6698), GDPR (EU 2016/679), and the NZ Privacy Act 2020 and Australian Privacy Principles.

You may request access, correction, deletion, or withdrawal of consent at any time by emailing privacy@oceanscapegroup.com
Consent & Acknowledgement
I consent to the secure cross-border transfer of my data to accredited providers in Türkiye for the purposes stated above.*

I consent
I consent to Oceanscape processing my personal and health information to assess eligibility and obtain a surgeon’s preliminary opinion.*

I consent
I understand that Oceanscape Group is a medical tourism facilitator, not a healthcare provider, and that all medical opinions and final treatment decisions are made by licensed surgeons and accredited hospitals in Türkiye.*

I understand
I understand that final approval for surgery depends on the medical assessment of my chosen surgeon and that completing this form does not constitute a confirmed booking or medical clearance.*

I understand
I agree to receive follow-up emails or messages about my enquiry and related services and understand I can withdraw this consent at any time.*

I agreeNo thank you
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DENTAL / SMILE DESIGN – Your Surgery Readiness Form

Section A - Personal Details

Section B - Readiness & Travel Experience

Section C - Health Information

Section D - Treatment Interest

Procedure History

Desired Outcome & Expectations

Please upload photos

Post Treatment Considerations

Section E — KVKK, GDPR & Privacy Consent

Consent & Acknowledgement