Request A Passport Support Letter

The following details are required before issuing a gender marker change support letter:

(Please note you must be an existing patient to make a request)

Are You On The Monthly Payment Plan?

Yes No

Full Previous Name

Full Current Name

Date of Gender Dysphoria Diagnosis

Mobile Number

Email Address

Date of Birth

Home Address Line 1

City

Postcode

Join Our Care

The Gender Hormone Clinic

Providing affirmative, patient centred gender affirming hormone therapy led by our expert nursing team and multi disciplinary team of psychiatrists, psychologists and surgeons.

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