• WEIGHT LOSS

    Successful, permanent weight loss
    is possible and affordable
    at COSTAMED.

    read more
  • DENTAL SERVICES

    Check out our incredible selection of dental services and give us a call
    to schedule your dental vacation!

    read more
  • PLASTIC SURGERY

    Our world-class cosmetic surgeons
    offer a wide range of
    plastic & cosmetic services.

    read more
  • MEDICAL SERVICES

    Discover why so many people are coming to COSTAMED for better healthcare!

    read more
  • CARDIOLOGY

    When a heart condition threatens your health, visit the experts
    at COSTAMED.

    read more

Request an Appointment at COSTAMED

Complete the following form to request an appointment at COSTAMED. A Patient Coordinator will contact you within 2 business days to review your medical and financial information, including insurance coverage, before an appointment will be scheduled.

Note: If you are experiencing a medical emergency, please dial: 01.800.900.1133 (inside méxico) & 855.301.4111 US

  • Cozumel: 987.872.9400
  • Playa del Carmen: 984.803.7777
  • Tulum: 984.124.0830
  • Mahahual: 983.834.5976

Please be assured that this online appointment request form is in a secure area and that information entered and submitted is confidential. You may also contact us by phone through our Front Desk at the corresponding facility. Calls may be monitored or recorded for quality purposes.

Attention: If you are not the intended patient, please be sure to fill this form out with the appropriate patient information.

All fields are required unless marked optional.

Telephone number: It is important for you to provide us with a phone number so that we can let you know if there are any last minute changes regarding your appointment.

Patient Information

Have you received treatment from one of our facilities before?

What location would you like to receive information about?* High recomended choose one*

Does the patient have health insurance?

Patient's Gender:

Patient's Gender:

Type of Patient:

Preferred Language:

Medical Concern or Procedures

Specialty Requested:

Please list symptoms, diagnosis if you've received one, and reason for your appointment request:

Date of onset or duration of current problem:

Recent pertinent tests or X-rays (include date of procedure) concerning this problem:

Are you currently using any medication for any reason?

If you would like to provide additional information to the appointment staff, please add it here:

Do you have any discount affiliations? Your credentials will be required at the time of your consultation.

 

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