Register your interest
Please fill out this form as best you can and we will be in touch shortly with further information.
First name
Last name
Email
Phone Number
Address (including postcode)
Current clinic address (including postcode)
Why are you interested in our service?
Profession
Doctor
Aesthetic doctor
Dentist
Nurse
Other medical professional
Aesthetic practitioner
Physio/OT/osteopath
Counsellor/therapist
Beauty therapist
Other
If other, please specify
If you are working in aesthetics, how long has this been for?
Less than 1yr
1-2 years
2-3 years
3-5 years
5-10 years
More than 10 years
Not working in aesthetics
Where do you currently practice?
Own clinic
Rent a room in a clinic
Rent rooms in multiple clinic locations
Home clinic
Mobile practitioner (travelling to clients' homes)
Indicate the type of room you would be interested in renting
Medical treatment room
Counselling room
Dental room
Minor ops theatre
Other
If other, please specify
How far would you be willing to travel to a clinic space?
0-1 miles
1-2 miles
2-5 miles
5-10 miles
10+ miles
Which locations would you be willing to travel to (pick one or more)?
Hammersmith
Shepherd's Bush
Chiswick
Fulham
Chelsea
Kensington
Clapham
Other
If other, please specify
What is your hourly budget for treatment room rental?
How many hours a week would you be looking to rent for?
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