Enquiry or Appointment EnquiryAppointment * Existing Patient: YesNo * Name: * DOB: * Mobile Phone: * Gender: MaleFemale * Email Address: * Nationality Patient’s Current Medical Conditions/Symptoms/Diagnosis: Preferred Doctor: Refer me to right SpecialistDr. Daniel Tan Yat HarnDr. Jonathan Teh Yi HuiDr David Tan Boon Harn Preferred Date: Preferred Time Slot: AnytimeAMPM I agree to the terms of use of Make an Enquiry / Appointment set out above. I consent to the collection, use and disclosure of my personal data given above to process the Enquiry / Appointment and such other related processes to facilitate and complete the Enquiry / Appointment, including monitoring and tracking any follow-up actions such as confirming my appointment. I would like to receive information and updated about your services and facilities to time.