In order to treat any hearing issue at the practice, we are required to triage all patients (including existing ones) before booking an appointment. Once you have completed the triage form, we will get in touch to arrange your appointment.

If you are under 18 or booking on behalf of someone under 18 then we will need to speak to you beforehand.

Please note, we require the details on this form to enable us to communicate with you and to provide you with the right service. To learn about how we protect and manage your details and comply with GDPR, view our privacy policy.

If you have any issues with this form please contact us directly on 01492 540000.

    Patient Details

    Please read the following statements carefully and tick those that apply.

    These checks are related specifically to Covid-19 to ensure the safety and well-being of our staff and patients.





    Ear Wax Removal

    If you’re booking an appointment for ear wax removal, we recommend using Earol (olive oil) for 2 days prior to your appointment.

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    Other Details

    Our Terms and Conditions