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Please complete this section if you're registering for Mole Mapping.
Dr Kukula doesn't work with BUPA UK, all fees must be paid directly by BUPA UK patients within 14 days from the consultation.
Dr Kukula doesn't work with Vitality, all fees must be paid directly by Vitality patients within 14 days from the consultation.
I understand that I am responsible for payment of all fees incurred. I will settle the fees by credit card, bank transfer or sending a cheque to Advanced Dermatology Clinic Ltd. within 14 days from the appointment date.
Initial Consultation: £330
Follow-up Consultation: £250
Liquid Nitrogen Treatment: £170 for 1-3 lesions; £260 for 4 or more lesions
Total Body Mole Mapping with an unlimited number of Sequential VideoDermoscopies (FotoFinder Master): £270
Sequential VideoDermoscopy of pigmented lesions (Medicam 1000i): £100 for 1-3 lesions; £150 for 4 or more
Skin Surgery as advised
Cancellations: It is crucial that you notify us of your cancellation at least 24 hrs prior to your appointment time, to avoid the £150 cancellation fee.
Please pay your fees within 14 days – we accept all major credit cards. Invoices unpaid for more than 30 days will incur and administrative charge of £20.
It is always advisable to check with your insurance company exactly what level of private cover you have, in order that you can avoid unexpected deficits from the Hospital, Castle Quay Medical Practice or the Consultant. Some policies will settle your medical bills in full, leaving you with no balance to pay, but an increasing number of schemes have varied restrictions and exclusions. Unfortunately, any shortfall will be due from you.
Any insurance details omitted from you, will mean the invoice will be your liability and all fees will be invoiced directly to you.
Data Protection and Patient Privacy
Please do not come to your appointment if you or any of your household members have any signs of the COVID-19 infection (Fever, cough, muscle pain, fatigue, other cold/flu symptoms). Please inform the Secretary - an alternative date will be offered.
Please wear a mask when attending your appointment at Castle Quay Medical Practice.
I understand that I am personally responsible for any insurance shortfall to be paid within 14 days from receiving the bill.