When completed click the submit
button and the form will be emailed;
Consent for Information Sharing
It is good medical practice to communicate with other professionals involved in your care so as to ensure the best possible treatment outcomes.
Dr Bernat will discuss with you a wide range of issues. Her normal practice is to prepare a report based on your consultation with a diagnosis and treatment plan to be sent to your GP, Consultant or any other Therapist involved, with a copy to yourself.
Please sign the form, date it and send to me at The Priory Hospital North London if you give consent for information to be shared with professionals involved in your care.