Covid-19 Online Screening

From 19th July 2021 we no longer need you to complete an online screening process. Masks and distancing in waiting areas are still in place – read more here.

Book straight in for treatment by having your condition assessed by our surgical nurses for free.

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Name*
Forename Surname
Date of Birth*
Day
Month
Year
Email Address*
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Phone Number*
House Number / Name*
Postcode*
Which clinic would you like to attend?*
Treatment of Interest*
You might need an in-clinic consultation.

Some procedures require an initial appointment with your Surgeon before treatment. You can still use this form and we will call you back to discuss next steps, but before proceeding to treatment you will need to book an in-clinic consultation with one of our Surgeons.

For the following treatments, please call to book an appointment:
- Rhinophyma treatment
- Earlobe Reduction
- Inverted Nipple Surgery
- Upper Blepharoplasty
To book, call us.
Upload photos*
Please upload clear image(s) of the area for our medical staff to review.
Drop files here or

Accepted file types: jpg, jpeg, gif, png, bmp, tiff, pdf, Max. file size: 60 MB, Max. files: 5.
How long have you had this condition?*
Any recent changes in your condition?*
Current and past medical history*
Are you using any medications?*
(prescribed and over-the-counter)
Do you have any allergies?*
Which clinic location would you prefer?*
- Leeds
- Newcastle / Gateshead
- Either
How did you hear about us?*
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Our Patient Care Team

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Covid-19 Online Screening

Our Patient Care Team

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