Please allow 1 working day for a confirmation on your appointment. It is also important to note that your request for an appointment is not confirmed until you receive a response from us. Please note that this is not a registration form to register you as a patient in the hospital. Thank you.

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Select Hospital *

Select Speciality

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Select Doctor

Preferred Appointment Date & Time (1st Choice)

Preferred Appointment Date & Time (2nd Choice)

Patient Full Name *

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Patient Date of Birth

Patient IC or Passport *

MRN (Medical Record Number)

Select Profession

Email *

Phone No. *

Is this appointment self-pay?
Yes
No

Company's GL or Insurance Policy

Email

info.kmc@tdmberhad.com.my

Make an Appointment

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