Preliminary Consultation Form

 

The Online Preliminary Consultation is a service offered to patients located outside the United Kingdom. It is designed to provide potential patients with general feedback and information in order to better decide whether to seek care in our office.

 

Please take time to fill out all questions on the form carefully and completely.

 

Dr Sorensen will review the submissions and determine whether you appear to be a suitable candidate for treatment. Your submissions will be followed up by a phone call from our staff within one working week. 

 

Please take special care in ensuring that photos you submit are of good quality and are made in accordance with the photo quality/size guidelines.

 

 

[Terms and Conditions]

 

[Photo Guidelines

 

 

  1.  
     
  2.  
     
  3. Attaching Photos

  4. You may attach up to 5 photos from your computer. Please review our guidelines and the photo quality/size requirements before attaching your files.
     
  5. Note: If for any reason you are unable to attach images to the form, you may email them separately along with a brief message clearly identifying yourself and the
  6.  
     
  7. Submitting your form

  8. If you wish to save a copy of this form, please print now before submitting.
  9.