PERSONAL INFORMATION

First Name:  
Last Name:  
Email Address:  
Phone Number:  
 
 
 
 

MEDICAL PROVIDER CONTACT INFORMATION

Facility Name:  
Facility Phone Number:  
Country:  
City/Province:  
Email Address:  
Website:  
 
 
 
 

CERTIFICATIONS & ACCREDITATIONS

JCI Certification (Y/N)  
ISO 9000 Certification (Y/N)  
Other Certifications  
   
   
US Board Certified Doctors (Y/N)  
US Board Certifications ABMS  
  ABPS  
  AOABS  
Beds Available  
International Patients in 2008  
Specialties & Procedures    
Anesthesiology Maxillofacial Surgery Physical Medicine and Rehabilitation
Cardiology Nephrology Plastic Surgery
Cardiovascular Surgery Neurosurgery Proctology
Clinical Neurophysiology Obstetrics and Gynaecology Pulmonology
Dermatology Oncology Radiology
Emergency Medicine Ophthalmology Rheumatology
Endocrinology Orthopedic Surgery Surgical Oncology
Gastroenterology Otolaryngology Thoracic Surgery
General Surgery Palliative Care Transplant Surgery
Hematology Pathology Urology
Hepatology Pediatric Surgery Vascular Surgery
Intensive Care Medicine Pediatrics