To have an appointment at a skin camouflage clinic you need a referral to be made for the appropriate clinic. For some of our clinics you can make a referral yourself, by completing the below form. Please note, this form works best on a computer screen, so may not function fully on smaller devices.
To find out which clinics you can refer yourself to please click here.
Please note that you cannot refer yourself to this service to cover a tattoo. If you would like skin camouflage to cover a tattoo you must get a referral from a health care professional by following the instructions above.
If you have any questions or concerns about filling in this form please contact the Skin Camouflage Team on 0300 012 0276 or email firstname.lastname@example.org.
Changing Faces will record your details on our secure database. Any details you give us will be used to correspond with you, and to enable us to provide you with our service. Subsequently, data will be used anonymously for statistical purposes only.