Haematology

Registration Form

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New Patient Registration

We are a private medical practice. A standard consultation fee is £300 and tests are additional. Please note there may be an additional fee for more complex consultations. By providing your phone number / email address / address you are consenting to be contacted with results and medical correspondence when necessary. This will not be used for any other purpose (e.g. marketing) and will not be shared.

Gender

Your Appointment

Please tell us the reason for your visit and your preferred time, date and location. This will allow us to ensure you are seen by the most appropriate team member. note by submitting this form you consent to pay our private clinic for all the services provided;

COVID-19 Questions

Have you recently had a recent positive CoViD - 19 test?
Do you have any of the following symptoms: runny nose, sore throat, cough, shortness of breath, fever?