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Digital consent form

* Denotes required field.

I hereby give consent for my care and treatment.

What is consent?

Your Wimbledon NeuroCare health professional will explain your procedure to you, in particular the intended benefits of the process, any risks involved, and available alternatives. You may be offered an information leaflet about your procedure or you can download a copy via our website.

Consent is the process by which you give permission to a health professional to provide your care and treatment. It may be implied, for example, by offering your arm for a blood pressure reading, or formal, by signing a formal consent form for an operation.

In either case, your consent must be given voluntarily and you must have all the information you need to make a decision. This includes what the procedure or treatment involves, the benefits and risks, the details of any alternative treatments and what may happen if the procedure or treatment does not go ahead.

How do I give consent at Wimbledon NeuroCare?

Consent is a two way process between you and your Wimbledon NeuroCare health professional. It is a chance for you to ask any questions, and for the Wimbledon NeuroCare health professional to explain what your procedure will involve.

It is Wimbledon NeuroCare’s policy that consent will be recorded on a consent form. The form enables the Wimbledon NeuroCare health professional to record the different aspects involved in consent and allows you to sign to show you agree. The form alone does not prove consent but it does confirm your joint discussion.

Where a person cannot give consent for themselves, for example if they are under 18 years of age, someone with allocated responsibility must sign the form on their behalf. Please ask your Wimbledon NeuroCare health professional for advice and for further information.

Important things you need to know

Patient choice is an important part of your care. You have the right to change your mind at any time, even after giving consent, and even if the procedure has started, as long as it is safe and practical to do so. However, there may be procedures you do not wish us to carry out and these can be recorded on the consent form.

We are unable to guarantee that a particular person will perform the procedure. However, the person undertaking the procedure will have the relevant experience.

All information we hold about you is stored under the provisions of the Data Protection Act 1998.

The consent form

Signed consent forms kept with your medical records. If you would like a copy, please ask your Wimbledon NeuroCare health professional.

Privacy and dignity

We are committed to treating all patients with privacy and dignity in a safe, clean and comfortable environment.

WNC is committed to protecting our patients and our staff from the Covid-19. We are continually monitoring government guidelines and advice from Public Health England to ensure our industry takes a united approach in ensuring the health, safety and wellbeing of our patients in tackling this virus.

WNC has developed a Virtual Therapy clinic that allows you to continue to access us for treatment that will allow you to continue with your rehab in the safety of your own home.

Our staff are working hard to ensure clinics continue as smoothly as possible, and with minimal disruption, so we can continue to assist and serve our patients through this difficult time. please contact our booking team on 020 3212 0830 or email us on

As the situation continues to develop we keep our patients updated. We will, of course, be returning to full operation as soon as it is safe to do so.

“We’ll meet again”

Her Majesty the Queen May 2020