Consultant Paediatric Surgeon Urologist London

Mr Misra responds to email queries within a day. Please feel free to share your concerns, and attach the case summary and any relevant documents for his review. He will provide a detailed feedback to you after consultation, explaining the patient management plan and proposed course of action.

General Practitioners (GP) Online Patient Referral Form

* Indicates required field

Patient's Name *

First

Last

Patient's Date of Birth *

Patient Gender *

Name by which the child is known (if different from above): *

GP's Contact Telephone *

GP's Email (used for feedback) *

GP Details (UK patients only) *

Medical Report (Please attach) *

Max file size: 20MB

Patient covered by health insurance? *

No Yes

Parent / Carer /Guardians Contact address *

Referring doctor/other involved in patient's care details *

Additional document (x-rays, scans etc.) *

Max file size: 20MB

Additional Comments *

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experienced & well-trained private paediatric urologist consultant surgeon in London UK

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