Patient Registration Form

Patient Registration Form

We value your time and privacy

To streamline the consultation process, we kindly request that you complete our secure online patient registration form. This essential information helps us to understand your unique needs and medical history better, ensuring a more personalised and efficient experience during your consultation.

Completing this form is a vital step toward providing you with the attentive care and tailored solutions you deserve, and we appreciate your cooperation in this process. Please complete all sections and read the Personal & Health Information Consent section at the end of this form. If you have any queries, please speak to one of our team members or Dr Sørensen.

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Please upload relevant photos of what you are trying to achieve or your current situation. This may help you get an earlier consult appointment or surgery.

Please only include pictures of your face if relevant to your enquiry.