Self Referral

Alternatively, call us on 01943 882 011 or email info@skinsurgeryclinic.co.uk.

Complete this form to be booked straight in for your procedure

Name*
Forename Surname
Date of Birth*
Date Format: DD slash MM slash YYYY
Email Address*
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Phone Number*
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Which clinic would you like to attend?*
Treatment of Interest*
You might need an in-clinic consultation.

Some procedures require an initial appointment with your Surgeon before treatment and so we can't offer Online Consultation. For the following treatments, please call to book an appointment:
- Rhinophyma treatment
- Earfold Prominent Ear Correction
- Earlobe Reduction
- Inverted Nipple Surgery
- Upper Blepharoplasty
To book, call 01943 882011.
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