Registration Form

PLEASE COMPLETE THIS FORM IN FULL AND CLICK ‘SUBMIT’ SO THAT WE CAN REGISTER YOU WITH OUR PRACTICE. PLEASE REVIEW OUR GDPR INFORMATION DISCLOSURE | POLICIES & PROCEDURES FORM HERE.

Name *
Name
Cancellation & Rescheduling Policy *
We operate a standard 48 hour cancellation/rescheduling policy. As such, if you need to cancel or reschedule please do provide us with a minimum of 48 hours notice. Payment will be required for sessions that are cancelled, rescheduled or missed with less than 48 hours notice.
Consent to Treatment & GDPR Procedures *
Please click on the link at the top or bottom of this page or go to the following link to read about our policies as well as our GDPR data protection procedures - www.drsiriharrison.com/policies-procedures-gdpr
Please note that we fully maintain your confidentiality according to legal and ethical standards. Your emergency person would only be contacted in the event of a true emergency.

PLEASE REVIEW OUR GDPR INFORMATION DISCLOSURE | POLICIES & PROCEDURES FORM HERE.