Multiple Specialist Request

This form is not for authorisation of treatment. Authorisation should be undertaken in the usual way with your patient contacting Customer Service.

For multiple specialist requests we need:

  • Each specialist's details
  • Explanation of why each specialist needs to be in surgery
  • Anticipated procedure length and an¬†indication of time in theatre for each specialist
  • Explanation of what each specialist will do
  • Indication of fees for each specialist
  • Any supporting clinical guidance.

If you need to upload more than one document, please upload your files here