Application for Rhinoplasty Consultation

This questionnaire is part of the practice’s triage process and is designed to assist with a better patient experience. In order to assess if Dr Dunlop is the right surgeon for you and your eligibility for the procedure at this practice, please complete the questionnaire. Our staff will contact you once assessed by Dr Dunlop. If we cannot offer you an appointment, you may still be able to use your referral to seek another surgeon.

    Please fill in and submit the following form. You are welcome to write N/A if the question is not applicable.

    The following genetic heritage question is relevant to the external and internal anatomy of the nose

    Thank you for completing this application. It is designed to save you time and money if you do not proceed with Dr Dunlop. Most senior surgeons subspecialise and we need to make sure you will be looked after by the right surgeon.