Female Patient Medical History
Please complete this form to the best of your knowledge. If there are any question you are uncertain about, do not worry. The details will be discussed with the doctor at the first appointment.
If you have any questions or queries, please do not hesitate to contact us.
If you have further information, medical records or otherwise, please bring them to the first appointment so that your doctor can review them.
BMI and Height information is required. This
information will be re-confirmed in Clinic. Please enter weight in stone or kg.
Have you ever undergone an operation? (If so, please give details of all operations including the year).