• Hand Holding Service

    What we do that really sets us apart from other companies providing surgery abroad, it is that we actually make a point of being with our patients throughout their visit.
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  • Great After Care

    We will support you and advise you FOR AT LEAST 2 YEARS AFTER YOUR WEIGHT LOSS SURGERY!!
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  • Affordable Prices

    Weight loss surgery at great prices with all packages including: accomodation, air fares, medication, hand holding and aftercare!
    Read More

Questionnaire Step 1: General Information

We provide an initial consultation where our surgeons can look at your medical history and relevant photos and let you know if surgery is appropriate and which procedure would give the best results.

When attaching photographs to your application, please make sure that you have all of the relevant photographs at hand so that you can upload them,. Details of how to upload them are given on the final page of the questionnaire. If you do not have any photographs in a digital format on your computer, details will be given on where to send the photographs prior to our surgeon's initial consultation. Please take the time to complete this questionnaire fully and carefully, because the answers you give will form the basis of your evaluation of acceptance for surgery.

NOTE: All fields are required

Section 1: Your Details
First Name
Surname
Address
Postcode
How would you like to be contacted?
Telephone Number
Email Address
Occupation
Date of Birth
Sex
Weight (please be accurate)
Height (please be accurate)
What procedure are you most interested in?
Ideal date for procedure
Important! Female clients please note: Please avoid planning your surgery procedure during the first 3 days of menstruation. All surgical procedures are strictly not permitted during pregnancy, if you are in any doubt please test before booking your procedure
Next of Kin/UK contact when abroad
Next of Kin's Address
Next of Kin's Telephone Number
General Practitioner's Name
General Pratitioner's Address
General Pratitioner's Telephone Number
Please note we will not contact your GP without your express permission.
How did you find out about www.cosmeticbliss.co.uk?
Please read through our Terms and Conditions, and check the box on the right to confirm you understand and agree to them.