Plastic Surgeon Profile Submission — ThPRS : สมาคมศัลยแพทย์ตกแต่งแห่งประเทศไทย

Plastic Surgeon Profile Submission

Description: This Google Form aims to gather information about plastic surgeons to create a comprehensive online profile for patients and the public. Please provide accurate and detailed information to ensure an informative and reliable profile. Thank you for your participation!

Full Name (ไทย)

Please enter your full name as it appears on your professional license.

First Name

Last Name

Full Name (ไทย)

Please enter your full name as it appears on your professional license.

First Name

Last Name

Email Address

Please provide your professional email address for verification purposes.

Phone Number

Please provide your professional phone number for contact and verification purposes

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Clinic/Hospital Name ,Address and Woking hour #1 (ไทย)

Please provide the name ,full address and working hour of the clinic or hospital where you currently practice.

Clinic/Hospital Name ,Address and Woking hour #1 (English)

Please provide the name ,full address and working hour of the clinic or hospital where you currently practice.

Text Clinic/Hospital Name ,Address and Woking hour #2 (ไทย)

Please provide the name ,full address and working hour of the clinic or hospital where you currently practice.

Clinic/Hospital Name ,Address and Woking hour #2 (English)

Please provide the name ,full address and working hour of the clinic or hospital where you currently practice.

Text Clinic/Hospital Name ,Address and Woking hour #3 (ไทย)

Please provide the name ,full address and working hour of the clinic or hospital where you currently practice.

Clinic/Hospital Name ,Address and Woking hour #3 (English)

Please provide the name ,full address and working hour of the clinic or hospital where you currently practice.

Board Certification(s)

Please list your board certification(s) and the certifying organization(s).

Medical School (ไทย)

Please provide the name of the medical school where you obtained your medical degree.

Medical School (English)

Please provide the name of the medical school where you obtained your medical degree.

Residency (ไทย)

Please provide the name of the institution where you completed your residency training in plastic surgery.

Residency (English)

Please provide the name of the institution where you completed your residency training in plastic surgery.

Fellowship (if applicable)(ไทย)

If you have completed any fellowship(s), please provide the name of the institution(s) and the subspecialty/area of focus.

Fellowship (if applicable)(English)

If you have completed any fellowship(s), please provide the name of the institution(s) and the subspecialty/area of focus.

Areas of Expertise (ไทย)

Please list your main areas of expertise within plastic surgery (e.g., rhinoplasty, breast augmentation, reconstructive surgery, etc.).

Areas of Expertise (English)

Please list your main areas of expertise within plastic surgery (e.g., rhinoplasty, breast augmentation, reconstructive surgery, etc.).

Professional Memberships

Please list any professional organizations or societies of which you are a member.

Awards and Recognition (if applicable)(ไทย)

Please list any awards or recognitions you have received related to your practice as a plastic surgeon.

Awards and Recognition (if applicable)(English)

Please list any awards or recognitions you have received related to your practice as a plastic surgeon.

Languages Spoken

Please list all languages in which you are fluent and can provide medical consultations.

Personal Statement (ไทย)

Please provide a brief personal statement highlighting your approach to patient care, your philosophy as a plastic surgeon, and any other relevant information.

Personal Statement (English)

Please provide a brief personal statement highlighting your approach to patient care, your philosophy as a plastic surgeon, and any other relevant information.