New Patient Registration Form

Please include details for your GP if different from referring doctor.

For nearly all patients, clinical photographs will be taken to assist in your care. These become a part of your confidential medical records. We also would like to ask you for permission to use these photos for educational purposes in addition to their use as part of your medical care. All images used for purposes other than the medical records are de-indentified. Names are not used and as far as possible identifying factors are masked.