Your Assessment

Complete Your Pre-Consultation Assessment

Submit your information securely before your consultation so the practice can better understand your concerns, medical background, and treatment interests.

Patient assessment and welcome at Dr Willem Erasmus practice

Pre-Consultation Assessment

A more informed starting point for your consultation

The online assessment helps the practice gather important information before your consultation, including your areas of concern, procedure interests, relevant medical background, and practical details needed for planning.

This allows your consultation to begin from a stronger foundation, making the discussion more focused, more efficient, and more relevant to your individual circumstances.

It is also a helpful first step for patients travelling from outside Cape Town or beginning the process remotely.

Why It Matters

What the assessment helps achieve

Completing the assessment in advance helps make your consultation more useful and better tailored to your needs.

Better consultation planning

The practice can review your information in advance and prepare for a more relevant consultation discussion.

Clearer understanding of your concerns

You can explain the areas you would like to address before the consultation begins.

More efficient use of time

Important background information is already captured, helping the consultation stay focused and productive.

Before You Submit

What to prepare

Having the right information ready will make your assessment easier to complete and more useful for consultation planning.

Your personal and contact details
The procedure or area of concern you want to discuss
Relevant medical and surgical history
Any allergies, medications, or prior treatment information
Clear notes about your goals, questions, or concerns

Before you submit

Why this information is requested

The pre-consultation assessment helps the practice understand your concerns, medical background, and treatment interests before your appointment. This allows the consultation to begin with better context and more focused planning.

It is not intended to replace a full consultation or medical examination. Instead, it supports a more informed first discussion by helping the practice review relevant details in advance.

Supports more informed consultation planning
Helpful for local, out-of-town, and international patients
Allows concerns and procedure interests to be reviewed in advance
Submitted for professional review by the practice
Used to support discussion, not as a final diagnosis

Online Assessment Form

Complete your assessment

Fill in the form below with as much relevant detail as possible. This information helps support a more informed consultation and treatment planning process.

Hidden

Next Steps: Sync an Email Add-On

To get the most out of your form, we suggest that you sync this form with an email add-on. To learn more about your email add-on options, visit the following page: (https://www.gravityforms.com/the-8-best-email-plugins-for-wordpress-in-2020). Important: Delete this tip before you publish the form.
Name(Required)
Email(Required)
Address
Procedure Interest
Face Procedures
Breast Procedures
Breast Procedures
Body Procedures
Body Procedures
1.front view 2.left side 3.right side 4.clear lighting
Max. file size: 32 MB.
Max. file size: 32 MB.

Consultation planning

Need help before submitting?

If you are unsure how to complete the assessment or would prefer assistance before submitting, contact the practice for guidance.

Frequently asked questions

Questions patients often ask before submitting

The pre-consultation assessment is designed to support a more informed and focused consultation. These answers help clarify what to expect before you complete the form.

What is the pre-consultation assessment?

It is an online form that allows the practice to review important background information before your consultation, including your concerns, medical history, and treatment interests.

Why should I complete it before my consultation?

Completing the assessment in advance helps the consultation begin with better context, making the discussion more focused, more efficient, and more relevant to your circumstances.

What information should I have ready?

You should be prepared to provide your contact details, the procedure or area of concern you would like to discuss, relevant medical and surgical history, and any notes about your goals or questions.

Can out-of-town or international patients complete the assessment?

Yes. The assessment is especially useful for patients outside Cape Town or those beginning the process remotely, because it allows the practice to review information before the consultation takes place.

Does the assessment replace a consultation?

No. The assessment supports consultation planning, but it does not replace a full consultation, examination, or formal discussion of treatment suitability and next steps.

What happens after I submit the form?

Once submitted, the information can be reviewed by the practice ahead of your consultation so the discussion can begin with a clearer understanding of your concerns and treatment interests.

Scroll to Top