Self-Referral Form for Laparoscopic Ovariectomy

Please complete the below form.

Please call the surgery on 01732 452333 when you have submitted a referral to ensure that we have received it and inform us whether it is routine, urgent or an emergency.


Please note that all referral clients will be subject to an initial consultation fee of £52.75  including VAT. An estimated cost can be provided once the referral submission and accompanying paperwork have been received.

We will contact you directly to book the appointment.