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

For post-operative uplift requests we will need operation notes and anaesthetic charts so we can understand the complications that arose during surgery, and an indication of the fee you wish to charge.

Uploaded documents must be clearly legible, or we won't be able to review your request. To keep our systems secure we can't accept documents with full stops in the file name itself. (So a file named Smith.05.05.doc, for example, needs to be renamed Smith-05-05.doc)

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