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Health Promotion Center : +82-2-2148-7485
  1. Step. 01 Request an appointment
  2. Step. 02 Review & Submit
  3. Step. 03 Finished

Our representative will respond within 2 work days after the confirmation

Preventative Health Screening Information

Preventative Health Screening Information
*Consent for disclosure of personal information
*Fill out the preferred
check-up date
*Describe preferred
check-up program
*Describe history of
medication intake
*Describe history of surgery,
medical treatment
Travel Agency Information
  • *Agency title
  • Person in charge
  • Telephone Number

Your Information

Patient Information
*First Name
*Last Name
Date of Birth
*Hotel Address
*Home Address
*Telephone Number