Hello,
Have you been on treatment for 3 months following your online consultation with Dr Benson? If yes, please complete this form to have a complimentary (free) follow up consultation.
This consultation is to review the progress made regarding your skin/hair/nail disorder and you would need to send in new photos of your skin/hair/nails taken in the same location, angles and lighting as the initial photos sent for consultation. Send your photos via this form AND include a screenshot of your prescription. Also send photos from your initial consultation for side by side comparison.
This form is NOT for seeking consultation for new conditions or pre-existing ones that were not mentioned during the initial consultation. You are responsible for remembering your 3 month follow up date and ensuring a submission on that date. This should be the day you started treatment. It is assumed that treatment is started no later than one month after a consultation. If it has been more than 3 months since you begun treatment or you started and stopped treatment at any point, you automatically forfeit this free follow up consultation unless Dr Benson was made aware of your challenges before the follow up consultation date and allowed an exemption.
In cases of forfeiture, you would need to pay a fee to have a consultation to assess what your new needs are. This usually costs 50% of the initial consultation fee, paid to the same account. Send evidence of payment to sirvclinic@gmail.com. This 50% payment also applies if you require another consultation for the same problem, after you have had the follow up consultation and were taken off medication. If you have a new skin/hair/nail disorder different from the one you had a consultation for, you would need to pay for a new consultation. Do not use this form.
Thank you for sticking with your prescription for 3 months! Best wishes.
