On-line Appointment Form


Full Name:
Patient Case Number:
Are you a new patient?
Yes No
Best contact number:
Email:


Type of appointment:
Standard Extended
Which clinic:
Maidenhead Slough London
Osteopath:
Robin Lansman Karen Phillips
Homeopath:
Dr Elena Gheorghiu
Please Note: Some Health Insurance Companies specify that you must consult a Named Practitioner Please check that the practitioner you have selected is the one specified.


Prefered Date:

Prefered Time:

:

Monday- Friday
9:00 - 18:00 (Last appointment -17:30)


  • After you make your on-line appointment request, you will receive an email confirming your Appointment Time, Date, Clinic Location and Practitioner.
  • Check these details carefully and let us know if there are any discrepancies.
  • Cancellations of appointments normally require 24 hours notice to avoid a fee being charged.
  • Your details will remain confidential and never passed on to a Third Party
  • Body Back-Up is registered with the Data Protection Act.


Security Number
Enter the number you see above


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