Bumrungrad Patient Inquiry Form

At IMT we want to make it easy for you to get treatment options and quality health care at Bumrungrad International Hospital in Bangkok Thailand.

Kindly fill the form below with your correct information to enable the specialists at Bumrungrad to provide you with the right treatment options within the shortest time possible.

All information and medical records will be treated confidentially.

Bumrungrad International Hospital Patient Inquiry Form

Please fill in the following details to get a Treatment Plan and Costing or a Second Opinion from the specialists at Bumrungrad

By clicking submit you agree to allow us to share your information with the specialists at Bumrungrad International Hospital and you agree to our Terms of Use and Privacy Policy.