Contact Harley Cosmetic Surgery Advocate

Questionnaire

Fill out a brief description and we will discuss the details more thoroughly once we have the basic outline.

When you submit this form, it will not automatically collect your details like name and email address unless you provide it yourself.

First name

Last name

Date of procedure and name of clinic/ Hospital?

Name of Surgeon

Which procedures did you ask for ?

What did you end up with?

Have you spoken to the surgeon - What did he tell you?

Were you rushed to A & E. if so what were the symptoms?

How has the botched surgery affected your mental health?

Have you reported the outcome to the GMC, if so have you had a response?

If your concerns are not addressed are you willing to seek legal help with a no win no fee solicitor or plan to pay for legal fees yourself?

For initial consultation and letter drafting £55