By providing the information set out in this form, I consent to Cardiac Vascular Sentral (Kuala Lumpur) Sdn. Bhd. (CVSKL) and their representatives, and/or agents collecting, using and disclosing my personal data to provide me with medical treatment and other reasonably related purposes. Such purposes are set out in the CVSKL Personal Notice. I further confirm that all personal data that I have provided are all true, up-to-date and accurate. Should there be any changes to any of my personal data, I shall notify CVSKL immediately.

I understand that I may withdraw such consent at any time by emailing us at opdweb@cvskl.com and info@cvskl.com.

Note:
Your requested appointment date and time is subject to availability. We will contact you within 3 working days after receiving your request to confirm your appointment.
Patients who require urgent medical attention, kindly call our 24-hour Emergency Department at +603 2276 7999.