Endometriosis contact request

This form is only for current patients of the endometriosis service

During this COVID-19 pandemic, we understand that this may be a difficult time for those of you awaiting surgery or follow-up appointments. While our gynaecology outpatient department is closed, you can read updates about the endometriosis service but do not attend your appointment in person.

If you are a current patient of the endometriosis service and have a question about how to manage your endometriosis symptoms during this time, please complete the form below to get in touch with a member of the endometriosis team.

Please bear in mind there may be a longer than usual response to your request as the whole team has been redeployed to other critical areas. But this would normally be within 7 working days excluding public holidays and service closures. We will only contact you on the supplied phone number if we need to clarify your details or request.

Important: This form is not to request or change routine appointments. Please contact the case manager in the appointments team on 020 3315 3236.


About you
Your date of birth   To confirm your identity
/ /  
About your query
Reason for contact  

characters remaining