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Endoscopy Referral Form

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Our Procedures

Upper and Lower Diagnostic & Therapeutic Endoscopy :

  • Gastroscopy
  • Colonoscopy
  • Flexible Sigmoidoscopy
  • Complex polyp removal by endoscopic mucosal resection (EMR)
  • Stricture dilatation & Stent insertion
  • Gastrointestinal bleeding

  • “I recognise the importance of a patient-centered medical experience, providing evidence-based seamless management, communicated clearly to patients. It’s a privilege to serve the communities of London and North London counties with high quality medical care and procedures”

Next steps ?

1.  Fill the Form below

2.  Plan a consultation with our specialists

3.  Get your procedure date

ENDOSCOPY UNIT DIRECT REFERRAL FORM

Referrer Informations

Will be use to send you the report

Patient's Informations

If your have preferences
Please add Medication & Dose.

Blood results :

Must be available for those marked*

Click or drag a file to this area to upload.

Combien font 4+4 ?

receptionist

Please call our dedicate team for more informations : 0748 3247 410

Or contact us via the form

Our specialists

    About Us

    Get the care you need, in the language you speak Consultations available in English, French, German, Arabic & Spanish*

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