Wellness Clinic Appointment Request Form

This service is provided by AMSUK GROUP Ltd at Suite 7, Native Space, Unit 12 Bourges View, Peterborough PE1 2FG. We have over 40 years experience in the Healthcare sector ranging from Accident and Emergecy Care to Primary Care. We know it's not always possible to access GP Services We can visit you and take the results to your GP where needed to ensure onward care through referrals are made.

Full Name*

First NameLast Name

NHS Number

Date of Birth*

Date

Contact Number

Please enter a valid phone number.

Email Address

example@example.com

Address

Street Address

Street Address Line 2

CityCounty

Postcode

GP surgery*

Surgery Name

Street Address

Town/CityCounty

Postcode

What date and time work best for you?

Any other specific date and time, if the above selection is not suitable.

Date

Hour MinutesAM/PM Option

Would you like to be notified about promotional services?

YesNo

My Products

Ear exam and irrigation single ear Product Image

Ear exam and irrigation single earSingle ear examination and irrigation

£18.00 Quantity
Item subtotal:£0.00

Ear examination and irrigation both ears Product Image

Ear examination and irrigation both ears Examination And irrigation of both ears

£40.00 Quantity

Blood pressure checksManual Blood pressure checks with sphygmomanometer and stethoscope. Sitting standing and both arms.

£25.00 Quantity

Urine dip testWe will provide a sterile sample pot we then dip the urine which helps detect issues such as infections and diabetes.

£20.00 Quantity

12 Lead ECGA full 12 lead ECG WITH 4 limb leads attached to wrists and ankles or shoulders and hips and 6 leads placed across the chest from the centre round to the left side

£30.00 Quantity

MOTFull assessment, Blood Pressure check, pulse rate Oxygen saturations, peak Flow, blood glucose test, urinalysis screen, 12 Lead ECG, Auscltation of chest and abdomen using stethoscope and a Neurological assessment. This all helps to detect early signs and allow for early intervention.

£60.00 Quantity

Wound careCheck on wounds, clean and redress, suture removal. Treat new wounds suture or glue wound closure

£50.00 Quantity

Total

£0.00

Payment Methods

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Wellness Clinic Request Form

Payment Methods