SurGal Clinic s.r.o.
Brno, Czech Republic
+420 702 207 885
If you are being treated for some chronic diseases (diabetes, cardiac disease, asthma, etc), please bring with you your last medical report to the hospital. Ask your GP for your regular medication list (name of medication, dosage and frequency of medication) and the list of diseases which you have been/are treated for.
I am fully aware that if any answer provided in this questionnaire is not true or complete, the operation can be cancelled with no refunds. The provider accepts no liability for damages occurred as a result of provision of untrue or incomplete information. This questionnaire is only provisional in a character and will be accompanied by a detailed preoperative examination. If this examination reveals any significant problem, the operation is delayed or cancelled, whichever is appropriate.