Weight Loss Enquiry Form

How can we help ...

First Name *

Last Name *

Email *

Contact Phone *

Can you help me with: *

A quote for Finance or KiwiSaver

A ballpark figure on how much a trip will cost me

I'm ready to make a booking

How soon would you like surgery? *

ASAP

3 - 6 months

6 - 12 months

Not sure

Which procedure are you considering? *

Gastric Sleeve

Gastric Bypass

Revision Surgery

Lap Band Removal & Revision Surgery

What country are you considering for surgery? *

Mexico

Thailand

Türkiye

Height (cm) *

Weight (kg) *

WL Enquiry BMI

It is helpful if we know what age group you are in.

Under 18

19 - 59

60 - 64

Over 65

We have helped people from all age brakets.

Do you have any medical conditions that may affect your ability to have surgery?

Tell us a bit about you and your journey so far.