Welcome to The Royals Assist!

We are delighted to have you here! At The Royals Assist, we believe that every post-op recovery journey should be treated with the utmost care, luxury, and personalization. As you prepare to embark on this path to rejuvenation and wellness, we kindly invite you to complete the form below. This will allow us to understand your needs and ensure that your experience with us is nothing short of royal.

Your comfort and recovery are our top priorities, and with the information you provide, we will tailor our services to meet your unique requirements. Whether it’s arranging personalized transportation, specialized care, or curated meal plans, we are here to make your recovery as smooth and luxurious as possible.

Thank you for choosing The Royals Assist. We look forward to assisting you on your journey to complete recovery and well-being.

Please fill out the form to proceed with your consultation.

First Name

Last Name

Email *

Phone *

Date of birth *

Favorite Color

Zodiac Sign

Element You Love The Best

What's your favorite food?

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Surgery Type

Doctor AND Clinic

Pre op day

Surgery date

Check In Date

Check Out Date

Name of Airline

Flight Departure Date

Flight Arrival Date

Any companions accompanying you?

Companion is:

Male

Female

N/A

Emergency Contact

Were you referred by a Royal? If so, who? Or where did you find out about our services?

Have you had weight loss surgery. If so when?

What kind of health insurance do you have?

*State Medicaid (recovery stay not an option)

Private insurance

Uninsured

Upload ID

Upload Insurance Card

Do you have any existing medical conditions that we should be made aware of?

Yes

Medical Conditions

Are you currently taking any medications now?

Yes

Current Medications

Any allergies?

Environmental

Food

Animal

Other

List food allergies below

in the box below please describe briefly the services you are interested in.

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Now, it’s time to book your welcome video call!