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GP Referral Form

GPs and other referrers can be confident that their patients will be in the capable hands of the LUA consultants who are all leading experts in their separate fields. Given the strength of our combined expertise, we are willing to take on the most complex of cases, as well as being available to provide additional urological information and discuss any specific queries you may have.

Please call our office on 020 7224 5089, send an email to info@lua.co.uk, or use the simple online form below for a quick and easy referral:

GP Name
GP Practice
GP Telephone
Referral Urgent
Urgent/Emergency       Routine
Patients Name
Patients D.O.B
Patients Address
Patients Home Number
Patients Mobile Number
Patient Email Address
Referral Letter
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Please click on the submit button once.