Section A Personal Information Full Name * Designation * Organisation / Company * Country * Business Address * Mobile Number * Malaysia (+60)Afghanistan (+93)Albania (+355)Algeria (+213)Andorra (+376)Angola (+244)Argentina (+54)Armenia (+374)Australia (+61)Austria (+43)Azerbaijan (+994)Bahrain (+973)Bangladesh (+880)Belarus (+375)Belgium (+32)Belize (+501)Bhutan (+975)Bolivia (+591)Bosnia & Herzegovina (+387)Botswana (+267)Brazil (+55)Brunei (+673)Bulgaria (+359)Cambodia (+855)Cameroon (+237)Canada (+1)Chile (+56)China (+86)Colombia (+57)Costa Rica (+506)Croatia (+385)Cyprus (+357)Czech Republic (+420)Denmark (+45)Dominican Republic (+1)Ecuador (+593)Egypt (+20)Estonia (+372)Ethiopia (+251)Finland (+358)France (+33)Georgia (+995)Germany (+49)Ghana (+233)Greece (+30)Hong Kong (+852)Hungary (+36)Iceland (+354)India (+91)Indonesia (+62)Iran (+98)Iraq (+964)Ireland (+353)Israel (+972)Italy (+39)Japan (+81)Jordan (+962)Kazakhstan (+7)Kenya (+254)Kuwait (+965)Laos (+856)Latvia (+371)Lebanon (+961)Lithuania (+370)Luxembourg (+352)Macau (+853)Maldives (+960)Malta (+356)Mauritius (+230)Mexico (+52)Mongolia (+976)Morocco (+212)Myanmar (+95)Nepal (+977)Netherlands (+31)New Zealand (+64)Nigeria (+234)Norway (+47)Oman (+968)Pakistan (+92)Papua New Guinea (+675)Philippines (+63)Poland (+48)Portugal (+351)Qatar (+974)Romania (+40)Russia (+7)Saudi Arabia (+966)Serbia (+381)Singapore (+65)Slovakia (+421)Slovenia (+386)South Africa (+27)South Korea (+82)Spain (+34)Sri Lanka (+94)Sweden (+46)Switzerland (+41)Taiwan (+886)Thailand (+66)Turkey (+90)Ukraine (+380)United Arab Emirates (+971)United Kingdom (+44)United States (+1)Uzbekistan (+998)Vietnam (+84)Zimbabwe (+263) Email Address * Company Website LinkedIn Profile Section B Company Profile Type of Organisation * HospitalMedical CentreMedical Tourism AgencyInsurance CompanyGovernment AgencyTravel AgencyHealthcare ProviderWellness CentreUniversityTechnology ProviderOther Years in Operation * Number of Employees * Annual Number of Medical Travellers Handled * Primary Markets Served MalaysiaIndonesiaBruneiSingaporePhilippinesThailandChinaAustraliaBangladeshSri LankaMiddle EastEurope Other Markets Section C Business Interests Services Interested In HospitalsSpecialist Medical ServicesHealth ScreeningOncologyCardiologyOrthopedicsFertilityRehabilitationDental CareWellness & Preventive HealthcareHealthy AgeingTraditional & Complementary MedicineAestheticsTelemedicineMedical ConciergeInsurance PartnershipsDigital Health Other Services Preferred Meeting Categories HospitalsSpecialist ClinicsWellness ResortsHotelsAirlinesMedical Tourism AgenciesInsurance CompaniesGovernment AgenciesTechnology ProvidersUniversitiesDiagnostic Laboratories Other Meeting Categories Section D Business Potential Patients / Clients Referred Annually Estimated Annual Healthcare Purchasing Value * RMUSD Countries You Currently Refer Patients To Decision Making Role Final Decision MakerRecommenderProcurementBusiness DevelopmentOwnerCEO Type of Partnerships Sought Preferred Companies / Organisations to Meet Section E Travel Information Passport Number * Passport Expiry Date * Arrival Date * Departure Date * Preferred Airport * Special Dietary Requirements * Accessibility Requirements Section F Accommodation Accommodation Required? * YesNo Preferred Room Type * SingleTwin Check-in Date * Check-out Date * Section G Flight Information Flight Assistance Required? * YesNo Preferred Departure City * Preferred Airline (if any) Section H Declaration I certify that the information provided is true and accurate. I understand that participation is subject to approval by the BGMT Organising Committee. I agree to attend all scheduled B2B meetings if selected as a Hosted Buyer. I have read and agree to the declaration above.