Health Screen Pre-Payment

LifeSmart Health Screens Booking Form

Please complete with the patient's details.
First Name*
Last Name*
Date of Birth*

DayMonthYear
Gender*
Your Email*
example@example.com
Mobile Number*
Billing Address*

Street Address

Street Address Line 2

City

Post CodeCountry
Booking your health screen

Please choose your preferred clinic(s), times and which health screen you would like to book.

We take full pre-payment for our Silver and Gold health screens. A 50% deposit is taken for our Platinum health screen. Then our health screen team will be in touch to book you in at a time and place that suits you.
Health screens are available at different locations:
- Oxford Street: Monday, Wednesday, Thursday & Friday
- Bank: Tuesday
- Liverpool Street: Thursday
- Kings Cross: Wednesday
We also have appointments available at Spire Bushey Hospital (Heathbourne Rd, Bushey WD23 1RD) on Thursdays. If you are interested at booking at this location please click here.
Preferred days(s)*

Monday (Oxford Street)Tuesday (Bank)Wednesday (Oxford Street & Kings Cross)Thursday (Oxford Street & Liverpool Street)Friday (Oxford Street)

Choose your health screen:*

LifeSmart Silver Screen (75 mins)£279.00

Recommended for all ages. This well person screen includes extensive assessments for major health conditions.

LifeSmart Gold Screen (90 mins)£650.00

Recommended for everyone over 40. This health screen includes a thorough examination and assessment which is designed to identify current and future health risks. As well as this you will get a full report from your doctor with recommendations.

LifeSmart Platinum Screen (90 mins)£475.00

Recommended for everyone, especially if you have specific health concerns. The extensive well person health screen includes extensive examinations and assessments to identify current and future health risks. LifeSmart Platinum provides you with the ultimate reassurance and safety net should any of your results raise concerns. (Remaining 50% payable in clinic).

ADD ON: WalkSmart£35.00

This add on is only available at Bank.

Enter coupon

Subtotal £0.00Shipping £0.00Total £0.00

Credit Card Details
First Name	Last Name
Credit Card Number	Security Code
Card Expiration

Subtotal
Additional Notes
Should be Empty:

LifeSmart Health Screens Booking Form