Skin Lesion / Mole Clinic Referrals

Are you over 18 years of age?

• Yes
• No

How many skin lesions do you have?

• 2 or less
• More than 2

Where is the skin lesion on your body?

• The skin lesions are not on my genitalia
• The skin lesions are on my genitalia

Do you think that your skin lesion is infected and/or a rash?

• Yes
• No

Have you had previous treatment for this lesion?

• Yes
• No

Is the lesion wet and/or open? If so, is it dressed in bandages?

• Yes
• No

Can the lesion clearly be seen? i.e. not covered by hair or a tattoo?

• Yes
• No

Are you able to get to the Clacton Diagnostic Centre?

• Yes
• No