Make an enquiry

Thank you for contacting Proton International London regarding proton beam therapy at University College Hospital.

We understand that time is critical when facing a cancer diagnosis, and our team is here to support you every step of the way. You can reach us at any time

You can speak to our helpful team by calling them on 0203 9255 885.

If you would like to refer yourself for a consultation, please complete the form below. The information requested in this form is essential for determining your eligibility for proton beam therapy. To avoid any delays, please complete as much of the form as possible. We aim to respond promptly to your enquiry.

For general enquiries, please visit our contact us page.

Patient Information Enquiry Form

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Thank you for contacting Proton International London regarding proton beam therapy at University College Hospital. We understand that time is of the essence when living with a cancer diagnosis. This form contains all the information we need to determine your eligibility for proton beam therapy. To avoid any delays, please complete as much of the information as possible. We aim to respond promptly to your enquiry.

About you

Your Name(Required)

First Last

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Enquiring for someone else

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Patient Information

First Last

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Address

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Cancer/tumour diagnosis(Required)

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Other

Please confirm the nature of your enquiry

How will you/the patient fund their consultation and/or treatment?

Please forward the following as Word or PDF documents (please avoid sending photographs of documents):

Medical reports from doctors currently treating the patient | PET scan/CT scan/MRI scan/x-ray imaging reports | Histopathology reports (following surgery/biopsy procedure)Operation notes/details| Imaging on disc (CD, DVD) or transferred electronically | Details of treatment already received, if known: Chemotherapy – names of drugs, number of cycles, dates of treatment | Radiotherapy –dose and number of fractions, dates of treatment | If you are unable to upload, please send all documents via email to padmin@protonintlondon.com

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Your enquiry

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Please note that if you attach multiple files to our enquiry form, the form may take longer to submit. Kindly click the submit button only once and wait for the confirmation screen.

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Got a question?

Do you have a question about proton beam therapy or want to learn more about our centre in London? For general enquiries, including how to find us, our contact details, or address, please visit the ‘Contact us’ page.

Cancers we treat