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Patient referral form

All information transmitted via this form will be held on a secure, double password protected database. NO patient information will be transmitted via email as this system will send notification of a new referral ONLY to the consultant.

Please enter the details for the referral here.

GP's Details
Patients Details
Referral Details

GP Referral

Private Health Care

Mr Alavala is recognised as an Orthopaedic Consultant by:

  • BUPA
  • Simply Health
  • Pru Health
  • WPA
  • Aviva