UKS UKS

UKS Medical Diagnostics Limited
328 Manchester Road, West Timperley, Cheshire WA14 5NH

Telephone: + 44 (0) 161 969 4000

Facsimile: + 44 (0) 161 969 4011

UKSMedical

Medical Examination Request

To be completed by GP/Consultant...

UKS Medical
Medical Examination Request

The referral request document below must be completed in full and signed by the referring GP/Consultant. Please ensure it is returned to UKS Medical Diagnostics by post or fax.

Patient Contact

On receipt of a completed referral request UKS Medical Diagnostics will contact the patient etiher by telephone or post and make all the necessary arrangements. A consent form authorising the results to be released to UKS Medical Diagnostics will be forwarded to the patient for signing.

Diagnostic Procedure And Results

On completion of the diagnostic procedure all results will be sent direct to the referring GP/Consultant unless UKS Medical Diagnostics are specifically requested to do otherwise.

Administration and Payment

A diagnostic procedure appointment cannot be made until the following conditions have been fulfilled:
Payment in full is received by UKS Medical Diagnostics, Patient consent document has been received, Referral document has been received.

Payment Methods

Payment must be made by the patient direct to UKS Medical Diagnostics. The following payment methods are acceptable: Credit/Debit Card (All Major Cards), Cheque (Funds must be cleared prior to appointment being made), Bank Transfer.

Full details will be forwarded to the patient on receipt of examination referral.