Informed consent for diagnostic ultrasound

Clinical informed consent form

Please complete our clinical information and diagnostic ultrasound consent form before your appointment

Diagnostic ultrasound Informed consent

Clinical information and informed consent 

Date picker instructions: 1. Click in the date field. 2. Double click on the month and year shown above the calendar 3. You now see a year range i.e 2000-2009 4. Click on the arrow to the left to cycle through the decades 5. Once you found your decade then click on your year of birth 6 .Click on the month of birth 7. Now select the day
Optional but not required
Optional but not required
If you have files or images that could be helpful for us to better understand the problem that we are seeing you for then please upload them below.
Max File Size: 5MB · Allowed File Types: jpg,png,pdf,docx,doc
Max File Size: 5MB · Allowed File Types: jpg,png,pdf,docx,doc
Max File Size: 5MB · Allowed File Types: jpg,png,pdf,docx,doc
Please read the following COVID-19 specific declaration and confirm you have read and agree.
Please note that opening encrypted documents might require certain computer settings and or software on your computer. If you experience any problems then please contact us.
I accept the terms and conditions as stated on this website and I have ticked all the declarations (square boxes)
Please write your signature in the box above
 Please make sure that all the required fields have been completed otherwise the form will not submit !

If you have problems submitting the form then contact us on: 07999 923844

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Injection information leaflets

Please see below a patient information leaflet discussing the additional risks of having steroid injections during the COVID pandemic published (23.10.2020)

Physiotherapy

Meet Rob - Our Specialist Physiotherapist/ Sonographer

Rob is a specialist Extended Scope Physiotherapist with more than 20 years experience in managing complex musculoskeletal conditions.

He uses diagnostic ultrasound as an extension of his clinical skills.  He is an interventional sonographer in a busy radiology department of a central London Foundation Trust Hospital .

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Find out more about Rob