A few questions about your medical history...

We need to know a few details about your medical history. The answers will be used to determine the treatment(s) used, so please answer all questions honestly and accurately.

GDPR/Data Protection:

The data supplied in this form will be stored electronically, and will be used solely in connection with tailoring and arranging your treatment programme. We may need to use your telephone number and/or email address in order to contact you to book appointments and discuss your treatment. We will never sell this, or any other information about you, or pass it to other clinics. Information entered into the Online Consultation Form is not used for marketing of any kind and will be used solely by CHC Aesthetics Ltd.

By submitting this form, I agree that CHC Aesthetics Ltd may contact me in connection with this enquiry and that the telephone and e-mail details supplied are correct.