REGISTRATION FORM

Registration Form

Registration Form

  • DD slash MM slash YYYY
  • Private Insurance


  • Fees:
    Total Body Mole Mapping with an unlimited number of Sequential VideoDermoscopies (FotoFinder Master): £290.
    Sequential VideoDermoscopy of pigmented lesions (Medicam 1000i): £100 for 1-3 lesions; £150 for 4 or more.
    Initial consultation £360, Follow-up consultation £280, Liquid Nitrogen Treatment £190-280 (in addition to the consultation fee).
    Surgical and Other Procedures as advised.

  • Payments – our clinic does not provide credit facilities, and all invoices must be settled in full on the day of your consultation or within 14 days for surgical treatment invoices and excess / insurance shortfall bills. We accept all major credit cards. Invoices not paid on a consultation day / within 14 days from receiving by mail / e-mail will incur an administrative charge of £30.

    Cancellations – It is crucial that you notify us of your cancellation at least 24 hours prior to your appointment time to avoid the £200 late cancellation/ no-show fee. We reserve the right to request any patient who has previously failed to attend an appointment to pre-pay in full for any further appointment they wish to book.

    If You Are Running Late – while we will always try to see a patient running late, if you arrive more than 10 minutes late, you may be asked to rebook for another date. Out of consideration to other patients who are booked after you, the duration of your consultation or appointment may be shortened if you have arrived late.

  • Data Protection and Patient Privacy
    The information on this registration form will be used by Advanced Dermatology Clinic, Castle Quay Medical Practice, Jersey General Hospital and Elite Surgical Centre (as appropriate) for the purposes of providing medical services and associated practice administration. Your personal data, including relevant details of your medical history, will be stored and may be shared with other healthcare providers such as your GP, other consultants and Jersey Health and Social Services. For further information regarding how we use, disclose and manage your data, please refer to Data Protection Information.

    Mole mapping usually lasts 40-50 minutes.

    Please do not come to your appointment if you or your household members have any signs of COVID-19 or other acute infections (fever, cough, muscle pain, fatigue, other cold/flu symptoms, diarrhoea) Please inform the Secretary – an alternative date will be offered.

Contact Us

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Mole Mapping Clinic
Rue de L'Etau
St Helier
JE2 3EH

We are located at the Castle Quay Medical Practice in the Harbour Reach building.

Waterfront underground car park, as well as a pharmacy with a full range of dermatological medications, are both conveniently located nearby.