This form is used by patients who wish to gift a service to another patient at the clinic. Please complete the form accurately to ensure proper processing.
Terms & Conditions:
The service is provided at Vitalia Clinics in Al Khobar, Kingdom of Saudi Arabia.
This gift is valid for one purchase only.
This gift cannot be exchanged for cash, transferred to another person, or extended beyond its expiration date.
The value of this gift is non-refundable and non-redeemable.
This gift is valid for 6 months from the date of payment.
This gift cannot be used if the payment receipt is lost.
The clinic bears no responsibility in case of loss or damage.
All services are subject to appropriate medical evaluation based on the beneficiary’s condition.
I confirm that all information provided is accurate, and I agree to the clinic terms and conditions regarding referral gifts.*