Request appointment

You have selected that you would like to proceed with an appointment. Please complete the attached request form and we will be in touch to arrange your first appointment.

You will also be able to set up an online account which gives you access to some tools and resources together with a community forum.

To the team at Dorset Pain Management Service

Hello, I would like to proceed with requesting an appointment with Dorset Pain Management Service.

  • Preferred contact phone number
  • I confirm that I have read the following information about email communications with the service
    Information about emails

    Dear Patient,

    Thank you for consenting to communicate with us via email.

    Dorset Healthcare is continually looking at improving how we communicate with you as a patient or as a carer. The Trust respecting your data would only communicate via email if you agreed and would only contact you for routine communications and information such as appointments, reminders, to inform you test results are available or to ask you to respond to a service survey. Please note you are responsible for ensuring that Dorset HealthCare has the most up to date email for you and that if you share use of the email address your information may become known to other parties.

    The Trust takes protecting your data very seriously and your email address will be kept securely as part of your clinical record on our systems. We will not share you contact details unless we need to help health or social care partners provide care for you.

    We might where you agree send you more sensitive information to your email address but we will need to send this in an encrypted form which we would discuss with you before we send it.

    We will not offer an emergency or urgent response service via email. If you have an urgent health need you should contact your GP, or 111 service for advice or if under the care of our Mental Health Services the appropriate Crisis service number.

    For more details please go to our Privacy Policy.

    Please be aware that whilst we will always make every effort to ensure we send your email to you in a safe and secure way we cannot guarantee that an email cannot be intercepted or that your own system could be hacked.

    It is your responsibility to ensure you have anti-virus products in use on your electronic device. You need to be aware if you share use of your email address with a partner, relative or carer that they will also have access to any messages we send you. If you have a nominated person who will receive emails on your behalf they must understand your need for confidentiality. The Trust will not take responsibility if your system security is breached.

  • I acknowledge the Data Protection (GDPR) and Confidentiality information here
  • Send

Once you have been added to the system, you will be able to access the platform using your NHS number. Usually this will happen within 3 days. If you are not able to access the platform within 10 days of your request, please email support@kyoh.org.