Diagnostic referral formsWimpole Street Non-Invasive Diagnostics

To refer a patient for diagnostics, please download the appropriate form below. Email the completed form to our diagnostic bookings team using the secure address: To discuss your enquiry, please phone +44 (0) 207 351 8186. 

Imaging Referral Form

Cardiology Referral Form

Respiratory Referral Form

Blood Request Form


Consultant appointments Wimpole Street Consulting Rooms

Referring patients to one of our specialists is quick and simple. Either submit an appointment request online here, email our customer services team on or call +44 (0)203 131 5130.




Watch our video to find out more about advanced imaging and diagnostics facilities available at 77 Wimpole Street: