Book an Appointment

Appointment Request Form

Complete the fields below and we'll get back to you as soon as possible to confirm your slot.

01 Appointment Details

Service Required * Please select a service.

Circumcision Category * Please select a circumcision category.

Minor Surgery Category * Please select a minor surgery category.

Orthopedic Care Category * Please select an orthopedic category.

Dermatology Category * Please select a dermatology category.

Select Doctor *

Dr Bustari Eddie General Practitioner

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Dr Nur Nabila Zulkifli General Practitioner

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Please select a doctor.

Symptoms / Notes

02 Personal Information

Full Name * Please enter your full name.

WhatsApp / Phone No. *

+60

Please enter a valid phone number.

Email Address * Please enter a valid email address.

MyKad / Patient ID * Please enter your MyKad / Patient ID.

03 Panel & Insurance

Panel / Insurance Provider

04 Communication Preferences

I agree to receive my appointment confirmation via WhatsApp * I consent to Klinik Bustari collecting and using my personal data for appointment management, in accordance with the Privacy Policy

* Required fields. Our team will contact you within 2 working hours to confirm your appointment.

Mon – Sat	8.00am – 1.00pm
	2.00pm – 5.00pm
	7.00pm – 9.30pm
Sunday	Closed
Public Holiday	9.00am – 12.00pm

Appointment Request Form

Step 2 of 2: Pay Your Deposit

Appointment Request Received!