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GetUcare

IMAGING | TRUST | CARE 

Service Request Form
SERVICES YOU REQUESTED
On-Site Pre-Diagnosis and Imaging Program in the UK

Central London – Harley Street / Marylebone, South-West London – New Malden, North London – Finchley, East London – Hornchurch, West Colchester, Heley-on-Thames, Clifton, Bristol Selly Oak -Birmingham

Nottingham City Centre, Leeds City Centre / Inner Leed/ Govan, Glasgow, Altrincham -Greater Manchester, Pacific Quay

Day and Time for Pre-Diagnosis and Imaging
Day
Month
Year
Time
HoursMinutes
Aftercare and Follow-Up Service Across
Patient's preferred date and time for Aftercare
Day
Month
Year
Time
HoursMinutes
Please specify who will provide the treatment services.

If you have decided to have your patient's aftercare treatment carried out in the UK, please inform us of any budget or limit you consider necessary for the procedures. This will clarify the responsibilities of both your clinic and our center, preventing any dissatisfaction or complaints from the patient later on.

See More About the Payment
How would you prefer us to contact you regarding your request?
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