Request an Appointment

Request an Appointment
at BLEZ Clinic PHROM PHONG

Experience attentive, multilingual care at our Phrom Phong Branch, just steps from BTS Phrom Phong.

▼ Skip directly to the Appointment Form

Prefer to Book via LINE?

📱 Book via LINE

Please add our official LINE account before contacting us.

Need the Asoke Branch instead?

📞 Urgent inquiries: 091-058-2424 (English/Thai/Japanese support)

Online Appointment Request

*Required fields

Please fill out the form to request your preferred time slot. We will reply within 2 days. An automatic confirmation will be sent to your email.

If your time is not available, we will offer another option. Thank you for your understanding.

    ■Have you visited BLEZ CLINIC Phrom Phong (Soi 24) branch before?*
    NoYes

    ■Full Name*required

    ■Phone Number (Mobile preferred)
    Please provide a number we can reach you on the appointment day.

    ■E-Mail Address*required

    ■Passport or Thai ID Card (optional)

    You may upload a copy of your passport or Thai ID card here.
    If you prefer, you can also bring it with you on the day of your visit or send it by email later.
    สำหรับผู้ป่วยคนไทย สามารถแนบสำเนาบัตรประชาชน หรือแสดงในวันที่มาพบแพทย์ก็ได้

    ■Appointment Date & Time*required
    ,
    OPEN HOURS:
    Weekdays: 10:00 am – 2:00 pm / 3:00 pm – 7:30 pm
    Weekends: 9:00 am – 2:00 pm / 3:00 pm – 5:30 pm
    Lunch Break: 2:00 pm – 3:00 pm
    Last Reception: 30 minutes before closing
    [Vitamin IV drips]: Please arrive by 7:00 pm (weekdays) / 5:00 pm (weekends)

    ■Type of Consultation※Multiple answers*required
    Work Permit CertificateDriving License CertificateSTI Check-upVitamin DripVaccinationHealth Check-upGeneral MedicineOnline ConsultationAllergy TestOthers
    ※If you selected "Others", please specify in the remarks section below.

    ■Remarks
    (If you have any special requests, or if you need your company name or tax ID included on the receipt, please let us know here.)

    By clicking on the button below, you declare your agreement

    Agree

    📧 You will receive an automatic confirmation email from info@blez-clinic.com.

    If you have any questions after submitting the form, feel free to email us at blezsoi24@blez-clinic.com.

    Please also check your junk/spam folder if our email is missing.