Skip to content
Surgical Assessment

Surgical Assessment Form

Please complete the sections below.

A patient manager will contact you the next working day.

Please note a lumbar MRI scan less than six months old is mandatory for your assessment. Depending on your condition, a lumbar CT scan may also be required. SpinePro is unable to progress cases without the above.

SpinePro is currently only able to assist patients who can self fund the treatment.

Personal Details

Sex
Contact preference

Patient Criteria

How long have you been suffering?
Have you been diagnosed with severe herniated or slipped discs?
Are you suffering with chronic sciatica and/or severe lower back pain?
Are you ready for surgery to permanently relieve your symptoms?
Are you willing to travel to Montpellier, France? Your stay would typically be 9 days in total.
Are you able to self-fund the treatment? (Typically £32K+)

Your Symptoms

  • Do you have pain in your legs (sciatica, cruralgia, neuralgia)?
    If yes, please tick the relevant areas in the diagram below:
    Body outline diagram Right Left
  • Do you have tingling or numbness in your legs?
  • Do you have a significant loss of strength in your legs?
  • Is the main pain...

Additional Information

By clicking submit, you consent to SpinePro sharing your personal data with CCV for diagnostic purposes based on information herein this website. Please see our Privacy Policy for further details of how we manage & use your personal data.