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  1. In order for us to help you arrange for an appointment to see Dr Gerald Tan, kindly fill in the form below.

    Please note that your appointment will not be confirmed until you receive an email or telephone call from us with the specific time and date of your appointment.

     

  2. Please Select
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  4. Name of Patient
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  5. NRIC/Passport No.
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  6. Email Address
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  7. Contact No.
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  8. Preferred Appointment
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  9. Preferred Time Slot:
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  10. Reason for Consultation
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  11. Name of Referring Dr
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