To have an appointment at a skin camouflage clinic you need a referral to be made. For some of our clinics you can make a referral yourself, by completing the below form. To find out which clinics you can refer yourself to please click here. The clinics which appear as green markers are ones where you can refer yourself. If you want an appointment at a clinic which is a pink marker, you need to speak to your GP or another health or social care professional and ask them to refer you to the service. Please give them our website details so that they can make a referral for you. The light blue markers are for internal referrals only which means only patients of the hospital where the clinic takes place are able to be referred there.
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 email@example.com.