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Thank you for completing this questionnaire, which is designed to find out a little about you and your recent and past medical history. In order to give you the most comprehensive opinion on your cancer and potential treatment we need to get as much information as possible. It helps us to understand how any treatment may affect you and your family. You do not need to answer each question perfectly but the more information the better for our consultant’s assessment of your case.
Your answers are confidential and will not be shared with anyone without your permission .You will be able to discuss your answers with any consultant assigned to your case. drgregwilson.co.uk will save your questionnaire securely and it will be encrypted if sent electronically.
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This section contains a few questions for Female patients only. As you selected your Gender as 'Male', we have skipped this section for you, If you want to change your response to the Gender question, Please jump to page 1 and change it to see these questions.
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Thank you for completing this questionnaire.
By pressing SUBMIT, I consent that my questionnaire will be sent to Dr Gregwilson's Office via encrypted secure email. I confirm that I agree to the use of my/the patient’s personal data as per the GDPR statement on Dr. Greg Wilson’s website homepage regarding the use and safeguarding of my/the patient’s personal information which will be sent to Dr. Greg Wilson’s office and team. I also accept that, by submitting this questionnaire/email, from a data management perspective, the individual referred to in the questionnaire/email is entering into a “doctor-patient relationship” with drgregwilson.co.uk.