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Patient Forms

Adult treatment consent form

Questions?

Simply call +44 (0) 1442 261 333 during opening hours to speak with a member of our Patient Liaison Team who will help you arrange your consultation. (No referral is needed.)

To help us match you with the most appropriate member of our Clinical Team, we recommend completing our brief online pre-appointment form:

  • You can fill it out before or after calling
  • It helps us understand your symptoms and medical history
  • Particularly useful if you’re unsure which professional you need
  • Not required if you already know which Clinical Team member you’d like to see

Please note: we are not treating new patients under the age of 18.
Opening hours are 9:00am to 5:00pm, Monday to Friday (excluding bank holidays).

© 2025 Breakspear Medical Group Ltd. All rights reserved.
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