Checkup Appointment | Severance Hospital

Checkup Appointment

Please contact us for any inquiries related to your appointment.
Phone : 82-2-2228-1004

Check-up program Download

Patient Information

* Necessary Input Information

Patient Information table Name, Date of Birth, Gender, Nationality, E-mail, Phone No, Address(Korea), Insurance Information
* Name
* Date of Birth
* Gender	Male Female
* Nationality
* E-mail	@
* Phone No.
* Address(Korea)
* Address(Home)
* Insurance	Yes None/Self pay true Korean national health insurance International health insurance

Appointment Details

* Necessary Input Information

Appointment Details table Preferred check-up program, Alien Register No., Passport No., Preferred Date, Status, Describe history of medication intake, Describe history of surgery, medical treatment, Comments, Automatic input prevention
* Preferred check-up program
Alien Register No.
Passport No.
* Preferred Date	~
Date of arrival in Korea
Departure date from Korea
* There is a gastroscopy in the program. Would you like to have it with sedatives? (The sedation costs 156,000 KRW.)	Yes No
Status	Business Travel Student Treatment Other
* Describe history of medication intake
* Describe history of surgery, medical treatment
(Female only) Have you had a mammogram within a year?	Yes No
Do you have any metal in your body?	Yes No
Do you have claustrophobia?	Yes No
Comments
* Automatic input prevention	Please write in the order you see

* Information on the Collection and Use of Personal Information

Information on the Collection and Use of Personal Information

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