CCC-001 Ear Micro-suction Questionnaire/Consent Form
If you would like an appointment for ear micro-suction, you must read the Patient information for ear micro-suction leaflet before your appointment and sign the following consent form.

Health Questions

Have you had your blood pressure checked in the past 6 months
If you're over the age of 40 and not on blood pressure tablets, would you like your blood pressure taken today?