Rhinoplasty/Blepharoplasty Discount Promo Inquiry Form

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Hello, Patient Partner!

Thank you for interest in The Medical City's Rhinoplasty and Blepharoplasty Promo. This form will be used to forward your inquiries and your interest to our Wellness and Aesthetic Institute.

If you have further questions, kindly visit the Wellness and Aesthetics Institute: 6/F Podium Bldg., The Medical City, Ortigas Avenue, Pasig City, Metro Manila, Philippines

In compliance with Data Privacy Act of 2012, The Medical City ensures that the information you provide will be kept strictly confidential and will only be processed, disclosed or shared upon your consent. By completing and submitting this form, you agree to the processing of your data in accordance with The Medical City Patient Privacy Policy.

Name (First, Middle, Last) *

Age *

Address *

Contact Number *

Email Address *

Do you have any specific questions or concerns?

By clicking AGREE you give consent to The Medical City to process your information for the registration and other marketing materials. You may withdraw your consent by calling 8988-1000/8988-7000. *

AGREE

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