Gary Atkin Consultant Surgeon

click for menu

Referral form

GP’s can complete this online referral form and we will organise an appointment for your patient.

Alternatively, please call 075 2224 2224 and speak to Hannah regarding your enquiry. If she is not available, please leave a message and she will try to return your call within 24 hours.

GP Name *

GP Practice/Address *

GP Telephone *

GP/Practice email *

Treatment status is: *

 Routine Urgent

Suspected cancer? *

 Yes No

Patient's name *

Patient's date of birth *

Patient's contact number *

Patient's email

Your Message *