Join Hyalo

For any health or social care service business providers to join the HyaloHealth service listings, please complete the following details as fully as possible.

Joining the HyaloHealth listing service is free of charge. Should you have any queries, please do not hesitate to email on

* An email confirmation will be sent to the applicant upon receipt and review of the below information.

Name of Applicant:*

Contact Email:*

Contact Telephone:*

Business Name:*

Business Address (including Postcode):*

Business Telephone:

Business Email Address:*

Business Web Address:

Business Category:*

e.g. Acupuncture, Dentist. It may be that your business covers different categories and therefore you may add multiple

Services Offered Within Company:*

Please break down the individual category into greater detail. E.g. if a dentist, what types of dentistry do you offer - general dentistry, implants, cosmetic dentistry, orthodontics, endodontics etc

Price Listings if Private:*

You may wish to limit this to your most commonly utilised services e.g. if a dentist then you may wish to provide details of a routine check-up, any investigation prices usually required such as x-rays, follow-up appointment prices, a hygienist review, an emergency appointment and any similar costs for children

Opening Times:*

Days and times including weekend days and times

Professional Staff:*

(including listings of any relevant qualifications). Please state full names and their roles e.g. dentist, hygienist

Membership with regulatory bodies:

Please list membership with any relevant regulatory bodies and professional organisations e.g. CQC (care quality commission), GMC (general medical council) etc.

May we provide a widget link directly to your CQC rating (if relevant)?:*

Do you offer Private Services?:

Do you offer NHS Services?:

Preferred mode of referral:*

e.g. Self-referral, GP-referral

Parking Facilities:

Please provide details of parking facilities either on site or close to your service. Details about disabled parking facilities are also useful for clients please.

Any further information you would like us to know?:

How this information is used

Your data will not be shared with third parties
You will only be contacted via the channels you have opted in to
Your data will only be stored for these purposes

Emails:

Tick this box if you would like to receive marketing emails

Enter not this field:

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When you have completed the form, please click the Send Details button ONCE to send

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