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New Consultants

As a new Consultant at Parkside, we want to ensure prospective patients can find out all about your services and how you can meet their healthcare needs. Please complete the form and ensure you have included all relevant details.

Title (Prof, Dr, Mr, Mrs, Miss...)

First Name

Surname

Languages spoken (other than English)

Job Title (e.g. Consultant Orthopaedic Surgeon)

GMC Number

Consortium

Appointment Tel Number

Appointment Fax Number

Email Address

Would you like your email address displayed on the website?
YesNo

Secretary Tel Number

Secretary Fax Number

Medical Qualifications

Year of Qualifications

Main NHS Base

Areas of Expertise (Please tick)
AcupunctureAllergiesBack Pain & Spinal ProblemsBody ContouringBone ScanningBowel Cancer ScreeningBreast BiopsiesBreast ClinicBreast ScreeningBreast SurgeryBreast Surgery (Cosmetic)Breath TestingCancer/ OncologyCardiologyCT ScanningDermatologyDiagnosticsDupuytren's ContractureEMG StudiesENT SurgeryESWTFacial SurgeryFoot & Ankle ProblemsGastroenterologyGeneral MedicineGeneral SurgeryGynaecologyHand & Wrist ProblemsHaematologyHeadache ClinicHealth ScreeningHeart ScreeningHip ProblemsKnee ProblemsMRI ScanningNeurologyNeurophysiotherapyNeurosurgeryNon-Surgical ProceduresNuclear MedicineOphthalmologyOral & Maxillofacial SurgeryOrthopaedics (Expert Orthopaedic Consultation)PaediatricsPain Management, Parkside Hospital at PutneyPhysiotherapyPlastic & Reconstructive SurgeryPrivate GP ServiceProstate Cancer ScreeningPTNSRapid Access ClinicRheumatologyShoulder & Elbow ProblemsSports InjuriesUrodynamicsUrologyVaricose VeinsWomen's Health PhysiotherapyX-ray & Ultrasound

Professional Memberships

Clinical Interests (Max 200 characters). Please use keywords only, separating interests with commas.

Training & Background (Max 350 characters)

Personal Profile (Max 350 characters). This area is for other information people may be interested in e.g. charities you support, awards, sporting achievements, family etc.

Timetable. Please tick your regular clinic times.
Mon am, Mon pm, Mon eve, Tues am, Tues pm, Tues eve, Wed am, Wed pm, Wed eve, Thurs am, Thurs pm, Thurs eve, Fri am, Fri pm, Fri eve, Sat am

Please specify if your sessions are Alternate weeks, Monthly, at Putney etc.