Pro Bono Programme

Apply for treatment

This form takes about ten minutes. Everything you write here is read only by the Feonix team who run the programme, and applying puts you under no obligation at all.

Your application is confidential. It is never shared outside the clinic.
Your story, photographs and case are never used publicly unless you give separate written permission — and refusing changes nothing about your application.
There is no cost at any stage, and no card details are ever taken.
If we can't help, we will tell you honestly and suggest where else to look.

About you

So we can contact you and confirm you meet the age requirement.

First name

Please enter your first name.

Last name

Please enter your last name.

Please enter a valid email address.

Mobile number

Please enter a contact number.

Date of birth

The programme is open to applicants aged 16 and over.

Please enter your date of birth.

Postcode — or nearest town

Our clinic is at 15 Little Park Street, Coventry CV1 2RN.

Please tell us roughly where you'd travel from.

Parent or guardian's name and contact number — required if you are 16 or 17; leave blank if you are 18 or over

As you are under 18, please give the name and contact number of a parent or guardian.

Your scarring

Write as much or as little as you're comfortable with. There are no wrong answers here.

How did the scarring happen?

Please choose an option.

Roughly when did the injury happen?

An approximate month and year is fine.

Are the scars still changing?

Which areas are affected? — tick all that apply

Please tick at least one area.

How would you describe the scars? — tick all that apply

Raised and firm Growing beyond the original wound Indented or pitted Darker than my skin Lighter than my skin Red or purple Tight / restricts movement Itchy or painful

Anything else you'd like us to know about them

Photographs — optional, up to four

Helpful but not required. JPEG, PNG, HEIC or WebP, up to four photographs, 8 MB each. Natural daylight, no filters, one close and one from a little further back. They are stored privately on our own system — never emailed, and never on the public website. If you'd rather not, that's fine.

Please check your photographs.

Medical history

Laser and microneedling treatments interact with certain medicines and conditions, so we need this before anyone plans your care. Beata will go through it again with you in person.

Your GP surgery

Please tell us which surgery you're registered with.

How does your skin react to sun?

Please choose an option.

Medicines you take regularly — write "none" if none

Please tell us, or write "none".

Any medical conditions we should know about — write "none" if none

Please tell us, or write "none".

Do any of these apply? — tick all that apply

I have taken Roaccutane or isotretinoin in the last 12 months I scar badly or form keloids easily I get cold sores I am pregnant or breastfeeding I've had recent sun exposure or used sunbeds in the last month I'm currently under a hospital specialist for this scarring

Treatment you've already had for these scars — optional

Access to care

The programme exists for people who can't get this treatment any other way, so it helps to know what you've already tried.

Have you asked the NHS about treatment?

Please choose an option.

If you were refused, what were you told? — optional

Why private treatment isn't within reach for you

We read this to understand your situation, not to test you.

Please tell us a little about your circumstances.

How the scarring affects your day-to-day life — optional

Getting to us

Treatment takes place at our clinic at 15 Little Park Street, Coventry CV1 2RN. It is a course spaced several weeks apart, usually over a number of months, so it's worth thinking about whether you can realistically get here.

When you're generally free

Please give us a rough idea.

How did you hear about the programme? — optional

Permissions

These are separate on purpose. Only the first three affect your application.

Please tick the three required permissions above.

We reply to every application. Please allow up to five working days.

Application received

Thank you for trusting us with this.

Your application has been received. Our clinical team will review it, and we'll be in touch within five working days — by email, unless you'd rather we called.

Places on the programme are limited, so we can't promise a place, but we reply to every application. We've also sent a short confirmation to your email address.

If anything changes in the meantime, please call us on 0333 772 1277.