For patients of Spot Check Clinic

Please complete these forms only if requested as part of your appointment booking/registration process or if requested to do so by a Spot check Clinic staff member.

Medical history form for new patients

This form is for new patients who have booked an appointment for a skin cancer check, mole mapping or assessment of 1-3 selected spots.

Please complete and submit this form at least 2 working days before your first appointment at Spot Check Clinic.

Cosmetic mole removal: photo upload form

This form is for people who have booked an appointment for cosmetic removal of a mole or skin lesion or would like to have their mole or skin lesion assessed by a doctor before booking a cosmetic mole removal appointment. Please ensure that you have high quality photos of the mole(s) you wish to have removed. Photos should be in focus and well lit without glare. For more information about how to photograph your moles, see our page about photographing your own moles.

Please complete and submit this form at least 2 working days before your mole removal appointment.

Permission to use clinical photographs

This form is only for patients of Spot Check Clinic who have been requested to complete it by a staff member.

We will never use your clinical photos for any purpose other than your clinical management, unless you have given express written permission.

You do not need to complete this form as part of your clinic registration process.

Complete this form only if requested by a Spot Check Clinic team member