Section 2 of the form below should be completed ONLY if you’re a new patient or if any of your details have changed.
Fields marked with an * are obligatory.
I will provide details for invoicing. I understand that I am liable for any excess payments, or for the full cost should the invoice remain unpaid after 60 days.
There may be a charge if less than 24 hours' notice of cancellation is given unless this is due to onset of fever.