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Your Ref:
NHS Number: 434 096 1671 Enfield Assessment Service

Hospital Number: 11214451 25 Crown Lane Southgate
6 Jun 2018 London N14 5SH Tel: 0208

702 3329 Fax: Email:
Private and Confidential to be opened by
addressee
Mr Simon P CORDELL
109 Burncroft Avenue
Enfield
Middlesex
EN3 7JQ

Dear Mr CORDELL

You have been referred to our Assessment Service for a New Patient Assessment. Unfortunately, I
have been unable to contact you to offer you an appointment.

I am now writing to you to advise you that an appointment has been scheduled for you and the details
are as follows:

Appointment 1

Clinic Crown Lane Clinic
Date/Time 15 Jun 2018 10:00:00
Intended Duration 60 mins Clinicians
Angela Hague / EIS
Address Crown Lane Clinic, Crown Lane, Southgate, London, N14 5SH

YOU NEED TO PHONE AND CONFIRM THIS APPOINTMENT WITHIN FIVE DAYS OF DATE ON
TOP OF THIS LETTER; OTHERWISE THIS APPOINTMENT WILL BE CANCELLED. PLEASE
SEE NOTE BELOW)

Please complete the enclosed questionnaire form, this is titled INFORMATION FORM (Consent
Form) and ETHNICITY FORM and bring it with you to your appointment, TOGETHER WITH THIS
APPT LETTER. You may want a member of your family or a close friend to accompany you when you
attend for Assessment. The appointment will last approximately up to 1 hour.

Failure to confirm your attendance will result in the above appointment being cancelled and
you may be discharged back to your referrer.

Yours sincerely

Beverley Campbell

CC: GP

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