IRANIAN MEDICAL TOURS 
  Iran medical tour
 

 

 

Why Iranian Medical Services?
  • Expert board-certified physicians
  • World class hospitals & clinics
  • Surgical specialties & subspecialties
  • Top quality medical services offered at incredibly low prices
  • Excellent nursing care & laboratory facilities
  • Latest technological advances
  • Iran is a beautiful country
It is a program to assist patients all around the world who would like to visit Iran and experience the combination of a nice treatment and a pleasant stay. If you are looking for:

  • consultation,

  • second opinion, or

  • treatment,

contact the Sireh group.
Patient Information
Patient Name *
 		Country *
Address *
 		Birth Date (mm/dd/yyyy)*
City *
 		Primary Language
 		Zip *
E-mail Address*
Confirm Email Address*
 		Occupation
 		Sex
Work Number
 		Home Number *
  		 Best Time to Contact
Medical Information
Patient's problem / diagnosis: *
Brief history of the problem: *
Previous treatment (s) received for the current problem:*
Other medical problem(s) / surgery(ies):*
 

Where do you want to treat / checkup :

Medical Service (s) Required:
Second Opinion Out-Patient Visit Hospital Admission / Surgery
Complementary Services Required:
Medical interpreter     
Accommodation        
Transportation      
Please indicate any special needs the patient might have: 
  
Preferences (if any): Appointment time:
  
Hospital's name:
  
Physician's name: 
  

Method of Payment / Insurance
Cash Government International Insurance
  

Contact Information: Contact Name:  
  
Relationship to the patient:
Self Physician Family member Other
Address:   

Phone:

                

 

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