Photo Upload

Photo Upload

USE ONLY IF REQUESTED BY THE PRACTICE. Unsolicited photos will be deleted.

Patient Details

Name *

Date of Birth *

Name of the Doctor or Nurse who will be reviewing the photo

Photo Upload – DO NOT upload any photos of private parts, even if your doctor has mistakenly told you so!

Maximum file size: 10MB

Further Details

Privacy Policy

We use your information to provide healthcare and update your medical record. We may share relevant information with NHS services involved in your care. For full details, please see our Privacy policy.

Consent

I agree to the privacy policy

If you are human, leave this field blank.

***USE ONLY IF REQUESTED BY THE PRACTICE. Unsolicited photos will be deleted.***

Patient Details

Privacy Policy

USE ONLY IF REQUESTED BY THE PRACTICE. Unsolicited photos will be deleted.