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Requesting an Appointment

All medical appointments can be made in person via phone, fax or e-mail for your convenience.

Business Hours

  • 8am to 5pm (Monday - Friday)

Contact Number

Patient Name
Patient`s Hospital ID Number (only for return patient)
Birthday (DD/MM/YYYY) ex)31 / 12 / 2013 Gender
Alien Registration Number
(if available)
Passport Number
Korean National Health
Referral from outside clinic (If No, please refer to Explanation on Insurance for Outpatients)
Other Health Insurance (If Yes, please refer to Explanation on Overseas Insurance for Outpatients)
Address in Korea
Permanent Address
Contact Number (in Korea) Telephone Number - -
Mobile/Cell Number - -
Fax Number - -
Emergency Contact Name
Relationship with
the Patient
Telephone Number - -
Request Date
* If you want to see a doctor within 1 week, please call 031-219-4311.
Signs & Symptoms

Consent to collect and use personal data

Items to be collected and used
Mandatory Fields Patient Name, Birthday, Nationality, Passport Number, Korean National Health Insurance, Referral from outside clinic, Other Health Insurance, Contact Number (in Korea) (Mobile/Cell Number, E-mail), Request Date, Signs & Symptoms
Choice Fields Patient`s Hospital ID Number, Alien Registration Number, Address in Korea, Permanent Address, Contact Number (in Korea)(Telephone Number, Fax Number), Emergency Contact(Name, Relationship with the Patient, Telephone Number), Comments
Purpose of collection and use Online Reservation
Possession period Unless otherwise it is required to be retained under applicable laws and regulations, any personal information will be destroyed immediately after the purposes of collecting and using the personal information are achieved.