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Dental Implants
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Doctors
Dr. Orhan Fahri Demir
Dr. Aysen Gur Usluer
Dr. Oguz Cortuk
Dr. Dt. Ilayda Askan
Tr. Senem Yildirim
Tr. Sebnem Kocaer KADAK
Dr. Dt. Mustafa Ayhan
Dr. Dt. Hasim Ural
Reviews
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Contact Us
Free Consultation
About
About Us
Why To Choose Us
Our Process
Treatments
Hair & Beard Transplant
Cosmetic & Plastic Procedures
Mommy Makeover
Non Surgical Treatments
Facelift - Neck Lift
Rhinoplasty
Breast Enlargement
Breast Uplift
Breast Reduction
Tummy Tuck
Liposuction in Turkey
Gynecomastia
Brazilian Butt Lift
Arm Lift - Thigh Lift
Dental Treatments
Dental Implants
Veneers
Crowns
Teeth Whitening
Doctors
Dr. Orhan Fahri Demir
Dr. Aysen Gur Usluer
Dr. Oguz Cortuk
Dr. Dt. Ilayda Askan
Tr. Senem Yildirim
Tr. Sebnem Kocaer KADAK
Dr. Dt. Mustafa Ayhan
Dr. Dt. Hasim Ural
Reviews
Blog
Testimonials
Referrals
Contact Us
+44 20 3290 1910
info@bestifygroup.com
English
German
Free Consultation
Medical History Form
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Medical History Form
1. Personal Information
Name Surname *
Date of Birth *
Gender *
Man
Woman
2. Contact Information
E-mail Address *
Phone Number *
Country *
Please select your country.
Afghanistan
Albania
Algeria
Andorra
Antigua and Barbuda
Argentina
Armenia
Australia
Austria
Azerbaijan
Bahamas
Bahrain
Bangladesh
Barbados
Belarus
Belize
Benin
Bhutan
Bolivia
Bosnia and Herzegovina
Botswana
Brazil
Brunei
Bulgaria
Burkina Faso
Burundi
Côte d'Ivoire
Cabo Verde
Cambodia
Cameroon
Canada
Central African Republic
Chad
Chile
China
Colombia
Comoros
Congo (Congo-Brazzaville)
Costa Rica
Croatia
Cuba
Cyprus
Czechia (Czech Republic)
Democratic Republic of the Congo
Denmark
Djibouti
Dominica
Dominican Republic
Ecuador
Egypt
El Salvador
Equatorial Guinea
Eritrea
Estonia
Eswatini (fmr. "Swaziland")
Ethiopia
Fiji
Finland
France
Gabon
Gambia
Georgia
Germany
Ghana
Greece
Grenada
Guatemala
Guinea
Guinea-Bissau
Guyana
Haiti
Holy See
Honduras
Hungary
Iceland
India
Indonesia
Iran
Iraq
Ireland
Israel
Italy
Jamaica
Jordan
Kazakhstan
Kenya
Kiribati
Kuwait
Kyrgyzstan
Laos
Latvia
Lebanon
Lesotho
Liberia
Libya
Liechtenstein
Lithuania
Luxembourg
Madagascar
Malawi
Malaysia
Maldives
Mali
Malta
Marshall Islands
Mauritania
Mauritius
Mexico
Micronesia
Moldova
Monaco
Mongolia
Montenegro
Morocco
Mozambique
Myanmar (formerly Burma)
Namibia
Nauru
Netherlands
New Zealand
Nicaragua
Niger
Nigeria
North Korea
North Macedonia
Norway
Oman
Pakistan
Palau
Palestine State
Panama
Papua New Guinea
Paraguay
Peru
Philippines
Poland
Portugal
Qatar
Romania
Russia
Rwanda
Saint Kitts and Nevis
Saint Lucia
Saint Vincent and the Grenadines
Samoa
San Marino
Sao Tome and Principe
Saudi Arabia
Senegal
Serbia
Seychelles
Sierra Leone
Singapore
Slovakia
Slovenia
Solomon Islands
Somalia
South Africa
South Korea
South Sudan
Spain
Sri Lanka
Sudan
Suriname
Sweden
Switzerland
Syria
Tajikistan
Tanzania
Thailand
Timor-Leste
Togo
Tonga
Trinidad and Tobago
Tunisia
Turkey
Turkmenistan
Tuvalu
Uganda
Ukraine
United Arab Emirates
United Kingdom
United States of America
Uruguay
Vanuatu
Venezuela
Vietnam
Yemen
Zambia
Zimbabwe
City *
Address *
Postal Code *
3. Appereance
Height in CM *
Weight in Kilograms *
4. Chronic Disease
Please make sure your information that below is correct.
Hearth Disease *
Yes
No
Chest Pain *
Yes
No
Heart Murmur *
Yes
No
High Blood Pressure *
Yes
No
Shortness of Breath *
Yes
No
Asthma/Emphysema *
Yes
No
Blood with Coughing *
Yes
No
Anesthetic Reaction *
Yes
No
Diabetes *
Yes
No
Thyroid Disease *
Yes
No
Arthritis *
Yes
No
Kidney Stones *
Yes
No
Blood in your Urine *
Yes
No
Stroke *
Yes
No
Nervous Disorder *
Yes
No
Blood Transfusion *
Yes
No
HIV *
Yes
No
Hepatitis *
Yes
No
Bleeding Tendency *
Yes
No
Stomach Ulcers *
Yes
No
Hernia Repairs *
Yes
No
Cancer *
Yes
No
Please list all the medications you are presently taking *
Add Medication
Are you Allergy to any medications? (Please Add if you have any)
Add Allergy
5. Habits
Do you smoke? *
Yes
No
Do you drink alcohol? *
Yes
No
Where did you hear us? *
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Service of interest
Arm Lift - Thigh Lift
Brazilian Butt Lift
Breast Enlargement
Breast Reduction
Breast Uplift
Cosmetic & Plastic Procedures
Crowns
Dental Implants
Dental Treatments
Facelift - Neck Lift
Gynecomastia
Hair & Beard Transplant
Hair Transplant
Liposuction in Turkey
Mommy Makeover
Non Surgical Treatments
Rhinoplasty
Teeth Whitening
Test
Tummy Tuck
Veneers
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