Self Referral

Immediate access to support for your eating related problem is possible if you pay privately. Ellern Mede offers a range of services and advice for private patients. Use this form to make an enquiry now.

Self-Pay Enquiry Form

Your details

Where did you hear about Ellern Mede?*

How would you like us to contact you?*

What time would you prefer to be contacted?*

Select a condition*

Type of treatment programme*

Please indicate your your preferred payment option* I will be funding treatmentI have insuranceOther



Please call Susan Ramwell on +44 (0)20 3 209 7900 ext 227 to find out more. Or alternatively please feel free to email us at [email protected] or complete this enquiry form. Alternatively read about the NHS Referral process.

Your enquiry will be handled in the strictest of confidence and responded to the same or next working day. You are welcome to read our patient confidentiality policy.

After submitting this enquiry, you will receive an initial call or email to discuss service, price and payment options. We would need to receive some medical information such as a GP or Consultant letter. Should you wish to proceed you would have an initial assessment appointment.

Funding or payment arrangements will be discussed prior to your first appointment. We will send you our Terms and Conditions. Payment is in advance of each appointment.