You (or a health professional acting on your behalf) have recently registered interest in our Skin Camouflage Service. We’re nearly ready to book your appointment but need a bit more information about you before we can do that.
Please complete the secure and confidential form below. Please note that we cannot book your appointment until you have filled in this form.
If you are in England, you will need your NHS number to hand when completing the form. You can find this on any written correspondence from your GP surgery or can get it by contacting them directly. Clients in Scotland will not be asked for this on the form.
What happens next? Once complete, a member of the skin camouflage team will assess your requirements, and you will be contacted to progress your referral when an appointment becomes available.