To refer yourself or your patient to the Skin Camouflage Service please choose the appropriate form from the menu below.
Please fill in all the fields in the relevant form. If any fields are not applicable please write ‘N/A’.
Please click here to check the waiting times at clinics before you complete a referral form.
Unless the waiting time for an appointment is longer, referrals are valid for six months.
If you would like another appointment after six months, you will need to have another referral submitted.
Please note that chaperones are not provided at appointments. If you would like to take someone with you to an appointment please do so.
Also, please note that if you require personal assistance at your appointment then you will need to bring an appropriate person with you.
We sometimes send emails to clients regarding their appointments. Please be aware that these might be directed to junk/spam folders rather than the inbox. Please check these folders regularly.
If you experience any problems, have any queries or do not receive a confirmation email after submitting a referral (please also check your junk folder), please contact the Skin Camouflage Service on 0300 012 0276 or email email@example.com.