New Patient Centre
New Patient Application Form
Seven minutes now, at home, in your own time. It means your first visit is spent examining you rather than filling in paperwork, and your practitioner walks into the room already knowing your story.
About 7 minutes · Works on your phone · Saves as you go
Seven minutes, at your pace
It saves as you go. Stop when you need to, come back on the same device, and pick up where you left off.
Private and secure
Held on our own server here in the UK, encrypted, and seen only by your practitioner and our reception team. Never sold, never shared.
Read before you arrive
Your practitioner reads it ahead of your first visit, so the appointment starts with your examination, not a clipboard.
What happens next
- You complete your applicationEverything we need to know before we see you, including what you are hoping we can help with.
- Secure your appointmentAppointments are paid in advance, because paying is what turns a provisional time into a confirmed one. Once your appointment is arranged, the payment link is at the end of the form.
- Visit one: your assessmentA thorough structural, postural, orthopaedic and neurological examination with your practitioner.
- Visit two: your report of findingsWhat we found, what can be done about it, how long it is likely to take and what it will cost.
Would you rather apply on paper? Telephone the clinic on 020 8941 4410 and we will post one to you, or arrive fifteen minutes early and complete it at reception. Either way, please bring a list of any medication you take.
Registered with the General Chiropractic CouncilYour data stays in the UKUK GDPR compliant