The Long Covid Clinic                      Medical Appointment Booking Questionnaire
Please complete the self-referral form below as accurately as possible. Note this form is for booking an appointment with one of our doctors only. If you wish to access any of our other services please email info@thelongcovidclinic.co.uk for information on how to book and pricing.

For self-referral please note it is essential to provide a secure email address for your GP Practice. Once the form is received the clinic will be in touch with you to arrange upload of photo ID.

If photo ID or a secure email for your GP are not available, unfortunately we cannot accept self-referrals and we will require a formal referral letter via a regulated healthcare professional.

For queries about the above, please email info@thelongcovidclinic.co.uk
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