Stafford Skincare - Lichfield
Dr. Anne Ward. Consultant Dermatologist

Clinic Forms
Please go to the "Contact" page if you would like to arrange an appointment or ask a question. The Contact Form is shorter and is all that is needed for the first contact.
This page has 3 Forms. You will be asked to fill out the relevant Form when booking your appointment. Everyone will need to fill out Form 1 - the Registration Form. People arranging an on-line video consultation, or sending photographs, will also need to fill out Form 2.
Form 3 is a screening checklist to be completed within 48 hours prior to your appointment, if you are attending the Clinic.
Before submitting your Forms, click here to read our Privacy Notice to find out why we need to collect this information from you, and what we do with your information.
Stafford Skincare - Lichfield
Dr. Anne Ward
Consultant Dermatologist
Form 1: Registration Form
Form 2: Consent Form
We ask that a Consent Form is completed if you are sending photographs or if you are attending an on-line consultation. Photographs should be sent to the secure email address: anneward@protonmail.com. On-line video consultations use a secure healthcare platform called Doxy.me.
Please click each of the boxes below to confirm that you have read and that you understand the information.
Form 3: Pre-Appointment Screening Checklist
Please tick the relevant boxes. Please send this Form within 48 hours before your appointment.