Healthcare Professionals

MyAccess Clinics offers virtual appointments for patients anywhere in the UK, suffering from long term conditions including: chronic pain, migraine, cancer-related pain, anxiety, PTSD, depression, sleep disorders and neurodevelopmental disorders

Refer a Patient

To refer a patient to a specialist at MyAccess Clinics, you can send a referral letter or alternatively complete the online referral form.

Refer a Patient

Please choose one of the following options

Options(Required)

Completing the online referral form

Attaching a referral letter

Patient Details

Title

Name(Required)

First Last

Patient's Phone Number(Required)

Patient's Email(Required)

Address

Street Address Address Line 2 City County / State / Region ZIP / Postal Code Country

Reason for referral

Presenting condition

Past medical history

Current treatment

Medication history

Referrer's details

Doctor's Name(Required)

Position(Required)

Specialist

Phone Number(Required)

Doctor's Email(Required)

GMC Number(Required)

Healthcare Professionals

Refer a Patient

Refer a Patient

Please choose one of the following options

Patient Details

Reason for referral

Referrer's details

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