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WhatsApp Phone no.
1- Which health condition do you primarily want a doctor consultation for? (You can select more than one.)
Endometriosis (Gynecologist)
Visual Snow Syndrome (Neurologist & Ophthalmologist)
Fibromyalgia (Rheumatologist / Physical Therapy & Rehabilitation Specialist)
2- Have you been officially diagnosed with any of these conditions?
Yes, I have an official diagnosis.
No, I only have symptoms.
If diagnosed, please provide the doctor’s name and hospital name:
3.a - Endometriosis symptoms:
Chronic pelvic pain
Painful menstrual periods
Infertility or difficulty conceiving
Digestive or bowel problems
Other:
3.b - Visual Snow Syndrome symptoms:
Persistent or intermittent "static" vision
Light sensitivity
Blurred vision or glare
Other:
3.c - Fibromyalgia symptoms:
Chronic widespread body pain
Muscle stiffness/tenderness
Persistent fatigue and sleep disturbances
Memory and concentration issues (“Fibro fog”)
Other:
4. Have you undergone any tests or medical evaluations related to these conditions?
Yes, I have test reports. (Can you share them with us?)
No, I haven’t had any tests yet.
If available, please specify the test type (MRI, blood test, etc.) and date:
5. Do you require any additional services during your treatment process?
Accommodation (Hotel or stay near the hospital)
Airport transfer
Guidance and translation
No, I only need a doctor consultation.
Enter an approximate date
Anything else you would like to say ?
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