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Live Surgery Application Form
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Live Surgery Application Form
Live Surgery
Your Name (required)
*
Email Address (required)
*
Your Phone
*
Date of Birth
*
Your Photo from Front
*
Your Photo from Left Side
*
Your Photo from Right Side
*
Your Photo from Up Side
*
How many times have you been operated before?
*
1
2
3
4
5
6+
* Required
2+19=?
*
In accordance with the provisions of KVKK, I allow my data to be processed and shared with surgeons who will perform live surgery.
*
I agree to be a live surgery candidate.
*
I allow my photos, which will be taken before and after the operation, to be shared live with the participating surgeons and used academically.
TRY ₺
TRY
EUR €
Euro