Online Appointment Form Request

Contact details

Full Name: (required)
Your Email: (required)
Best contact Number:
Patient Case Number:
Are you a new patient?: (required)
 Yes No

Appointment Details

Duration of appointment (required):Initial Consultation for New Patients
 30 Min Standard first appointment 45 Min Extended first appointment "60 Min Extended first appointment"

Duration of appointment (required):When you have consulted us within the last 3 years
 30 Min Standard follow up 45 Min Extended follow up 60 Min Double follow up

Extended Appointments
  • Coming from abroad or from across the UK?
  • Got a complex problem?
  • Had a road traffic accident or seen many practitioners?
  • Have X-rays & MRI reports for case review?
  • Or just need more time?
    • Recommended for post follow up appointments – you have seen us before
    • New Patients Robin Lansman in Maidenhead
    • Recommended for post follow up appointment - you have seen us before
    • New Patients Robin Lansman in Maidenhead
    • Recommended for patients traveling from outside the local area or overseas
    • New patients for Robin Lansman in Maida Vale
    • New Patients for Karen Phillips in Maidenhead
    • Longer New Patient slot Robin Lansman Maidenhead
    • Recommended for patients traveling from outside the local area or overseas

    Type of appointment: (required) These options are normally extended sessions to allow time for assessment and review and appropriate treatment
     BackPain Orthotics Review standard appointment Pregnancy first appointment Workstation Health Review Thoracic Outlet Syndrome (TOS) Other
    If other, please specify

    Which Clinic (required):
     Maidenhead W9 Maida Vale

    • Robin Lansman works in Maidenhead on Mondays and Wednesdays
    • Karen Phillips works Tuesdays, Thursdays and Fridays
    • Marelie Mey works Mondays, Wednesdays,Thursdays and Saturdays
    • Barney Polden works Fridays only
    • Robin Lansman works in Maida Vale on Tuesday, Thursday and Fridays

    Osteopath: (required)
     Robin Lansman D.O. Principle Karen Philips D.O. Senior Associate Marelie Mey M.Ost ND DO BarneyPolden BOst (Hons)

    Preferred Date & Time:

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

    Insurance

     I am planning on using Health Insurance

    My insurance is with:

    If other, please specify

    Claim Number

    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.

    Important Information

    • After you make your on-line appointment request, you will receive an email confirming your Appointment Time, Date, Clinic Location and Practitioner.
    • Your on-line appointment request will only be responded to within working hours Monday – Friday 9am -5:30pm.
    • 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.


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Cards-accepted BODY BACKUP

             Osteopathy – Maidenhead Berkshire

        Robin Lansman D.O.  Principle &        Associate

Initial  Consultation       Robin Lansman D.O. 30 Mins

60 Mins

 £78.00

£95.00

Follow Up Consultations  Robin Lansman D.O. 30 Mins   £65.00
*Extended Consultation Robin Lansman D.O. 45 Mins

60 Mins

  £85.00

£115.00

Initial  Consultation   Associates 45 Mins  £69.00
Follow Up Consultation  Associates 30 Mins

45 Mins

 £60.00

£73.50