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Departments Target
Orthopaedics
Orthopaedics
Treatments
Services
Cardiology
Cardiology
Treatments
Services
Scanning
Scanning
Treatments
Services
Fertility Services
Fertility Services
Treatments
Services
Pain Management
Pain Management
Treatments
Services
GP Services
GP Services
Treatments
Services
Ear, Nose & Throat (ENT)
Ear, Nose & Throat (ENT)
Treatments
Services
Oral and Maxillofacial
Oral and Maxillofacial
Treatments
Services
Hepatology
Hepatology
Treatments
Services
Gastroenterology
Gastroenterology
Treatments
Services
Minor Surgery
Minor Surgery
Treatments
Services
Health Screening
Health Screening
Treatments
Services
Urology
Urology
Treatments
Services
Cancer Screening
Cancer Screening
Treatments
Services
Ophthalmology
Ophthalmology
Treatments
Services
Dermatology
Dermatology
Treatments
Services
Physiotherapy
Physiotherapy
Treatments
Services
Sports Medicine
Sports Medicine
Treatments
Services
Cosmetic Services
Cosmetic Services
Treatments
Services
Treatments Source
MRI Scan
MRI Scan
Ultrasound Scan
Ultrasound Scan
X-Ray
X-Ray
CT Scanning
CT Scanning
Tongue Tie
Tongue Tie
Cryotherapy
Cryotherapy
Trucheck
Trucheck
Prostate Screening
Prostate Screening
Cysts and Lipomas Removal
Cysts and Lipomas Removal
Cystoscopy
Cystoscopy
TMJ
TMJ
ECG
ECG
Echocardiogram
Echocardiogram
Cardiac MRI
Cardiac MRI
Shockwave Therapy
Shockwave Therapy
Physiotherapy
Physiotherapy
Acupuncture
Acupuncture
Massage
Massage
Sports MRI Scanning
Sports MRI Scanning
Blood Profiling
Blood Profiling
Spirometry
Spirometry
Cardiac Screening for Sports & Events
Cardiac Screening for Sports & Events
Urine Testing and Drug Screening
Urine Testing and Drug Screening
Visual Acuity and Colour Blindness Test
Visual Acuity and Colour Blindness Test
Sports CT Scanning
Sports CT Scanning
Sports X-ray
Sports X-ray
Sports Ultrasound
Sports Ultrasound
Pitchside Booking
Pitchside Booking
Pain Injection Treatments
Pain Injection Treatments
Flow Rate Test
Flow Rate Test
Ear Treatments
Ear Treatments
Nose Treatments
Nose Treatments
Throat Treatments
Throat Treatments
Pre-Signing Medical
Pre-Signing Medical
Upper Blepharoplasty (Eyelid Surgery)
Upper Blepharoplasty (Eyelid Surgery)
Mole and Skin Tag Removal
Mole and Skin Tag Removal
Prostate MRI Scanning
Prostate MRI Scanning
Private GP
Private GP
Earlobe Correction
Earlobe Correction
OCT Eye Scanning
OCT Eye Scanning
Deformity Correction
Deformity Correction
Arthrodesis
Arthrodesis
Arthroscopic Knee Surgery
Arthroscopic Knee Surgery
Knee Replacement
Knee Replacement
Knee Arthritis
Knee Arthritis
Ligament Reconstruction (ACL)
Ligament Reconstruction (ACL)
Skin Cancer Treatment
Skin Cancer Treatment
Fundus Photography
Fundus Photography
Visual Fields Test
Visual Fields Test
PSA Testing
PSA Testing
Spinal and Thoracic Injections
Spinal and Thoracic Injections
Joint Injections
Joint Injections
TP Prostate Biopsy
TP Prostate Biopsy
GP Referrals for Insurance
GP Referrals for Insurance
Fertility Assessment
Fertility Assessment
Reproductive Surgery
Reproductive Surgery
Recurrent Miscarriage
Recurrent Miscarriage
Gynaecology Services
Gynaecology Services
Cardiac Exercise Tolerance Test
Cardiac Exercise Tolerance Test
Health & Lifestyle Screening
Health & Lifestyle Screening
Women’s Health Screening
Women’s Health Screening
Cardiac CT
Cardiac CT
Blood Pressure, Heart Rate and Waist to Hip Ratio
Blood Pressure, Heart Rate and Waist to Hip Ratio
Cardiac Blood Tests
Cardiac Blood Tests
24-72 Hour or 7-Day ECG Monitoring
24-72 Hour or 7-Day ECG Monitoring
24-Hour Blood Pressure Monitoring
24-Hour Blood Pressure Monitoring
Bladder Scan
Bladder Scan
SRY Gender Testing
SRY Gender Testing
Concussion
Concussion
Sigmoidoscopy
Sigmoidoscopy
PRGF Endoret Injections
PRGF Endoret Injections
Radiofrequency Treatments
Radiofrequency Treatments
qFIT Home Test
qFIT Home Test
Arthrosamid Injections
Arthrosamid Injections
Gastroscopy
Gastroscopy
Endoscopy
Endoscopy
PRP Injections
PRP Injections
Colonoscopy
Colonoscopy
Shoulder Pain Treatment
Shoulder Pain Treatment
Bowel Screening
Bowel Screening
Hand and Wrist Pain Treatment
Hand and Wrist Pain Treatment
Ankle Pain Treatment
Ankle Pain Treatment
Foot Pain Treatment
Foot Pain Treatment
Hip Pain Treatment
Hip Pain Treatment
Cardiac Consultation
Cardiac Consultation
Ear, Nose and Throat (ENT) Consultation
Ear, Nose and Throat (ENT) Consultation
Elbow Pain Treatment
Elbow Pain Treatment
Knee Pain Treatment
Knee Pain Treatment
Spine Pain Treatment
Spine Pain Treatment
Services Source
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Player Name *
Name of Parent/Guardian (if the patient is under 18 Years Old)
Player Date of Birth *
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Referring Club*
Email for report *
Name of Referrer *
Diagnostic Tests Required
*Additional body parts (if you selected MRI 1 Part, or another service marked with an *, please specificy additional body parts below)
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“I was nervous but you was professional polite and caring thank you 😊”

Aaron Campbell

23

February 2026

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