Opening mid-June at Westfield London. Register your interest to be first to know. Email us

Pre-consultation form

Cancer Screening

These questions help us understand your risk factors and screening history so your doctor can recommend the right tests for you. Filling this in is optional but helpful - it means your consultation time is spent on planning, not paperwork. Takes about 5 minutes.

~10 minutes 7 short sections Confidential
Just getting started 0 of 7 sections
Select all types of cancer screening of interest
Family history is a major risk factor for many cancers
If you don't know your BMI, select 'Don't know' - we can measure this
Previous radiotherapy increases risk of secondary cancers in the treated area
Immunosuppression increases risk of certain cancers
Please list all regular medications and doses
Any other concerns, symptoms, or information that might be relevant

Here's what you've told us. Have a quick check, then hit send - this means your consultation can focus on what actually matters to you.

Your details

Name
Email
Phone
Date of birth

Screening Interest

Which cancer screening are you interested in? -

Family History

Do you have a family history of cancer? -

Previous Screening

Have you had previous cancer screening? -

Lifestyle Risk Factors

Smoking status -
Do you drink alcohol? -
Body Mass Index (BMI) category -
Physical activity level -

General Medical History

HPV vaccination status -
Previous radiation exposure (e.g. radiotherapy, occupational)? -
Are you immunosuppressed or on immunosuppressive medication? -
Are you taking any regular medications? -
Is there anything else you would like us to know? -
Previous screening results or referral letters.
Your information is sent securely to your doctor at LoveMyLife. We will not share your details with third parties. By submitting this form, you consent to LoveMyLife contacting you regarding your appointment.