It is good practice that we inform your GP but if you cannot provide their details we will provide you with a
letter to give to your GP. If you are under the care of any other health care professional please provide full
Thick the box if any of the statements below apply to you and provide details in the comments section below
if you answered yes to any of the above please provide details
Allergies and Sensitivities
As a process of pre-admission we may need to request documentation from your GP or other health care
provider. Wherever necessary, we would appreciate if you could forward any medical test results you have
received in the last 6 months directly to your patient coordinator.
Please provide details of who is accompanying after the surgery or who will be with you at home in the first 24-48 hours.