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Start an Enquiry
  • Services & Treatment
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      • Dermatology
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      • Aesthetic Medicine & Cosmetic Treatments
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  • Partners
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      • Dermatology
      • Cosmetic Medicine
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      • Aesthetic Medicine & Cosmetic Treatments
      • Skin aesthetic Wellness Transformations
      • Hair Restoration
    • Women’s Health
    • Wellness & Preventative Health
    • Other Healthcare Services
  • Partners
    • RS InMedika
    • GiO Dental
    • The Solitaire
    • Uluwatu Dental
    • NgoerahSun WAC
    • Cocoon Medical Spa
    • Bali Luxe
    • BIMC Siloam
    • NuLook
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Step 1 of 7

14%

PLASTIC & RECONSTRUCTIVE SURGERY
ENQUIRY FORM

InMedika Hospital Bali — International Surgical Services
Medical Tourism Program   |   International Patients Welcome
ℹ Please complete all sections marked * before submission. This form enables our surgical team to prepare your telemedicine consultation. All information is treated as strictly confidential.

1. PERSONAL DETAILS

Name(Required)
MM slash DD slash YYYY
Gender(Required)
Country of residence(Required)
Australian state / city

2. REFERRAL SOURCE

3. TREATMENT YOU ARE SEEKING

What Treatment You're Seeking Of:(Required)
Do you have recent photos, medical reports or previous surgical notes to share?(Required)
Max. file size: 512 MB.

4. BUDGET (OPTIONAL)

Budget:
Your budget is completely optional to disclose. Sharing it helps our team prepare a treatment plan that aligns with your goals and financial expectations.

5. TRAVEL & STAY

MM slash DD slash YYYY
MM slash DD slash YYYY
Assistance in Bali — please tick all that apply:(Required)

6. HEALTH & MEDICAL

Smoking / vaping / nicotine(Required)
Pregnant or breastfeeding?(Required)
Previous adverse anaesthetic or surgical reaction?(Required)
Level of surgery anxiety(Required)

7. CONSENT & DECLARATION

Consent(Required)
Consent(Required)
Consent(Required)
Consent(Required)
Clear Signature

YOUR PATIENT JOURNEY — INQUIRY TO AFTERCARE

What happens after you submit this form

1

Inquiry received

Your form is reviewed within 1 business day and the next step for surgical review is confirmed.

2

Telemedicine consultation

A video consultation is scheduled at a suitable time. Photos, medical details and goals are reviewed.

Preliminary only; in-person assessment is required.
3

Treatment pathway & estimate issued

You may receive a proposed pathway, cost estimate in IDR/AUD and appointment or surgery dates.

Indicative until in-person assessment.
4

Billing terms & deposit

Any required deposit, cancellation terms and inclusions are stated in your written estimate.

5

Arrival, hospital meet and greet

Your PIC assists with registration and guides you to consultation or admissions.

6

In-person assessment & pre-operative checks

Your treating team confirms suitability, explains risks, obtains consent and arranges required pre-operative tests.

7

Surgery, recovery & payment

Your procedure is performed by the treating team. Payment follows the written estimate and hospital terms.

8

Post-operative care & follow-up

You receive aftercare instructions, follow-up details and emergency contact information.

WhatsApp aftercare support where included.

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 Important Disclaimer

TJC Group Pty Ltd does not provide medical advice, diagnosis, treatment, or clinical recommendations. All healthcare decisions should be made in consultation with appropriately qualified healthcare professionals. Information provided by TJC Group is intended for educational and informational purposes only.

Medical Disclaimer:

This post is provided for educational purposes only and does not constitute medical or dental advice. Individual treatment requirements, outcomes, risks and suitability vary between patients and should be discussed directly with appropriately qualified healthcare professionals.

Services & Treatment Categories

TJC Group supports Australians seeking information, education, and guidance regarding a broad range of healthcare options available in Bali and Indonesia. The organisation does not provide medical treatment or medical advice, but helps patients understand their options, ask the right questions, and make informed decisions.

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