Quote for Finance/KiwiSaver

We charge an $80 fee for a quote, which must be paid upfront.

If you would like to proceed, please provide a screenshot of the payment. Once payment is received, we'll provide your quote within 48 hours.

Account Name: Portleo

Bank: ANZ

Account Number: 01-0877-0778142-14

Please add your name as the reference

Upload Screenshot of Payment *

PERSONAL DETAILS

First Name *

Last Name *

Email *

Height (cm) *

Weight (kg) *

Date of birth (DD/MM/YYY)

Surgery Details

Which Weight Loss Surgery? *

What county are you considering? *

Mexico

Thailand

Türkiye

Do you think you may need a Hernia repair?

Yes

No

Trip Details

WL Quote Departure Airport

What type of trip are you considering? *

Escorted (Trim Up group trip)

Go it alone (Trim Up arranges surgery and pays hospital)

Are you happy to share a room? *

I'd like my own room (extra charge)

I'm happy to share a room (Same Sex)

How long would you like to be away? *

Standard Trip

Holiday Trip (Mexico Only)

Are there any other details that we should consider when providing your quote?

Companion Details

Are you bringing a companion? *

Yes

No

Companion Accommodation

My companion will stay at the Hotel or Recovery House

My companion will stay at the Hospital with me