Eterno360

VAT Assessment Questionnaire

Please complete this before your treatment is booked. It takes about 10 minutes.

Why we are asking you these questions

Most cosmetic procedures carry VAT at the standard rate (currently 20%). A procedure is only exempt from VAT where its principal purpose is the protection, maintenance or restoration of your health. That test looks at the main clinical purpose of the treatment — not at what the treatment is called, and not at how pleased you are with the result.

Following the Upper Tribunal's 2025 decision in Illuminate Skin Clinics Ltd v HMRC, working this out involves weighing several things together: any diagnosis that has been made, the symptoms you have, the nature of the procedure, the circumstances in which you came to consult us, your understanding of the aim of the procedure, and your surgeon's understanding of the aim.

Two things follow from that, and we want to be straightforward with you about both:

Wanting to look better, feel more confident or improve your self-esteem is a completely legitimate reason to have treatment, and we will look after you just the same. But on its own it is not a basis for VAT exemption.
Your surgeon, not this questionnaire, makes the final decision. This form records your side of the picture so that it can be weighed alongside the clinical assessment.

Please answer as accurately as you can. There is no "right" answer, and answering in a way that does not reflect your true position could affect both your invoice and your care.

How we handle your information

The answers you give here are health information (special category personal data under UK GDPR). We process it to provide you with healthcare (Article 9(2)(h)) and to meet our legal obligations in relation to tax (Article 6(1)(c)). Your completed questionnaire is filed in your medical record and may be shown to our accountants or to HMRC if they ask us to justify the VAT treatment of your invoice. It is retained with your clinical records in line with our retention policy. You can ask us for a copy, or ask us to correct it, at any time. Full details are in our privacy notice.

Setup note — this message is only shown to you, never to a patient. This page has been opened directly from a file on the computer rather than from a web address. Browsers block form submissions in that situation, so nothing will be emailed. Upload the file to the website and test it from its real address (e.g. https://eterno360.com/vat-questionnaire.html).

1. About you and the treatment

So we can file this correctly against your record.

Full name *

Date of birth *

Email address *

Telephone

Which treatment or procedure are you considering? *

If more than one, please list them all.

Which surgeon or practitioner have you seen? *

Date of your consultation

2. How you came to consider this treatment

The route by which someone comes to a clinic is one of the factors that has to be weighed.

How did you first come to consider this treatment? *

My GP referred me Another doctor or specialist referred me A health professional treating me for something else suggested it It was raised as part of my recovery from an illness, injury or operation I approached the clinic myself after my own research or seeing it advertised It was recommended to me by a friend or family member I have had this or a similar treatment before and want it again Something else

Please tell us more

Has any doctor, nurse or other health professional advised or recommended that you have this treatment? *

Yes No I'm not sure

Who advised you, in what role, and roughly when?

Do you have a referral letter, clinic letter or report about this that we could add to your record?

Yes, and I can send it to you Yes, but it is held by my GP or another clinic No

3. Physical symptoms

By "symptoms" we mean things you physically feel or that physically limit you — not how the area looks.

Are you experiencing any physical symptoms in the area you want treated? *

Yes No

Which of these apply? Tick all that you have.

Pain or aching Discomfort, heaviness or pressure Skin irritation, soreness, rash or breakdown Recurrent infection Bleeding, crusting or ulceration Itching Numbness or altered sensation Obstruction or narrowing of my field of vision Eyes watering, dryness, or trouble closing the eyes Eye strain or heaviness when reading or driving Headache or brow ache from holding the brows up Difficulty breathing through the nose Restricted movement Difficulty keeping the area clean or dry Difficulty wearing glasses, clothing or a prosthesis Something else

Please describe it

How long have you had them?

Are they changing?

In an average week, how often do they trouble you?

Every day Most days Occasionally Rarely

Do these symptoms interfere with any of the following? Tick all that apply.

Driving Reading or screen use Work or study Sleep Exercise or physical activity Washing, dressing or personal care None of these

In your own words, how do these symptoms affect you day to day?

Have you tried anything else to relieve these symptoms? Tick all that apply.

Seen my GP about it Prescribed medication Over-the-counter treatments Spectacles or an optometry review Physiotherapy Dermatology or prescribed skin treatment Dressings, taping or supports Weight loss A previous operation or procedure Nothing yet

What did you try, and what happened?

4. Medical background

Whether there is an underlying condition, and whether it has been diagnosed, carries real weight.

Is the concern you want treated connected with any of the following? Tick all that apply. *

Present from birth Injury, accident or trauma A burn Previous surgery Cancer, or treatment for cancer A skin condition (acne scarring, eczema, hidradenitis…) A neurological condition (facial palsy, ptosis, nerve injury…) A thyroid or other hormonal condition An autoimmune or inflammatory condition Infection Significant weight loss Pregnancy and childbirth The natural process of ageing None of these, or I'm not sure

Please give brief details and approximate dates

Has a doctor or other health professional given you a diagnosis relating to this concern? *

A diagnosis means a named condition identified by a clinician — not simply a description of how something looks.

Yes No I'm not sure

What is the diagnosis, who made it, and roughly when?

Are you currently under the care of a GP or specialist for this concern?

Yes I have been in the past, but not now No

Who, and for what?

Anything else in your medical history or current medication that is relevant?

Optional, but helpful. Leave blank if nothing comes to mind.

5. How this affects you

These questions are here so we can look after you properly. Please answer them honestly.

Feeling self-conscious or unhappy about your appearance is common and completely understandable. We want to know about it because it matters to your care. Please be aware, though, that on its own it does not make a procedure VAT-exempt — that requires findings of a medical nature.

Have you ever been diagnosed with a mental health condition by a doctor, psychologist or psychiatrist? *

Yes No I'd rather not say

What was the diagnosis, and roughly when?

Is that condition related to, or made worse by, the concern you are seeking treatment for?

Yes, directly Partly No, it's separate

Are you currently receiving any treatment for your mental health — medication, counselling or therapy?

Yes No I'd rather not say

Please give brief details

On most days, how much does this concern affect your mood or your daily life? *

Not at all A little Moderately A lot Severely

A few more questions. You've told us this is affecting you a fair amount. The next questions are part of routine good practice in cosmetic surgery — they help your surgeon make sure that treatment is the right answer for you. They are not part of the VAT assessment.

Do you spend more than an hour a day, in total, thinking about this feature?

Yes No

Do you find it hard to stop thinking about it, even when you try?

Yes No

Do you find yourself repeatedly checking it, measuring it, or covering it up?

Yes No

Have you avoided work, social occasions, photographs or relationships because of it?

Yes No

Would you say this has caused you significant distress, or got in the way of your life?

Yes No

Thank you for telling us. Some of your answers suggest this is weighing on you quite heavily. Your surgeon will want to talk this through with you properly before any decision about treatment is made. That is a normal and important part of good care, and it is not a barrier — it is us doing our job.

6. What you are hoping for

This section carries the most weight of all. Please answer it in the way that is truest for you.

In your own words, what is the main thing you hope this procedure will achieve? *

A couple of sentences is plenty.

Which single statement comes closest to your main reason? *

To relieve physical symptoms I am experiencing To treat or manage a condition a doctor has diagnosed To prevent a specific health problem a doctor has told me I am at risk of To restore my appearance to how it was before an illness, injury or operation To change or improve my appearance It is genuinely a mixture of the above

If you had to divide your reasons, roughly where would you put yourself? *

Entirely about relieving physical symptoms or treating a diagnosed condition Entirely about changing how I look

Not yet answered — move the slider to set your answer.

Suppose your physical symptoms could be completely relieved, but your appearance stayed exactly as it is now. Would you still want this procedure? *

Yes, I would still want it No, I wouldn't need it I'm not sure I don't have physical symptoms

And the other way round: suppose your appearance could be improved exactly as you'd like, but any physical symptoms stayed exactly the same. Would you still want this procedure? *

Yes, I would still want it No, I wouldn't I'm not sure

Is there anything else you would like your surgeon to know?

7. Declaration

Please read these and tick each one.

The information I have given here is true and complete to the best of my knowledge.

I understand that the VAT position is determined by my surgeon on clinical grounds, that any result shown by this questionnaire is indicative only, and that it may change following clinical assessment.

I understand these answers will be held as part of my medical record, and may be shared with the practice's professional advisers or with HMRC if needed to support the VAT treatment of my invoice.

I understand that giving inaccurate information could affect both my invoice and my clinical care.

Type your full name as your signature *

Date

Your answers, and what they suggest

Nothing has been sent yet. Read this through — you can go back and change anything.

One separate point. Some of your answers about how this is affecting you suggest your surgeon should talk it through with you before any decision about treatment. This is about your care, not about VAT, and it does not count for or against the VAT position either way.

How each factor reads

These are the considerations the Upper Tribunal set out in Illuminate Skin Clinics Ltd v HMRC for deciding the principal purpose of a procedure.

Your answers in full

Check these over before you send them.

Before you send. If anything above doesn't reflect your real position, go back and correct it — that is exactly what the review step is for. Please don't change answers in order to reach a particular VAT result; an inaccurate questionnaire is worse than no questionnaire, for you and for us.

Thank you — we've received your questionnaire

Your answers have been sent to the clinic and will be added to your record. Your surgeon will review them alongside the clinical assessment and confirm the VAT position on your treatment plan or invoice.

If anything changes, or you realise something was incomplete, just let us know and we can update it.

Your full summary is below — including what pointed towards a health purpose and what pointed towards a cosmetic one. Please keep a copy.

VAT Assessment Questionnaire — your copy

How each factor reads

These are the considerations the Upper Tribunal set out in Illuminate Skin Clinics Ltd v HMRC for deciding the principal purpose of a procedure.

The answers you gave

Please remember: the result above is indicative only. It is based on what you have told us, and it is not a decision. Your surgeon determines the VAT position on clinical grounds after assessing you, and will confirm it in writing on your treatment plan or invoice. If you think anything here is wrong or incomplete, contact the clinic quoting your reference and we will correct it.

A note on what this questionnaire is and isn't

This form gathers information. It does not decide anything. The VAT liability of your treatment is determined by your treating clinician, applying the principal purpose test in Group 7, Schedule 9 of the Value Added Tax Act 1994 and HMRC's guidance in VAT Notice 701/57, in light of the Upper Tribunal's decision in Illuminate Skin Clinics Ltd v HMRC [2025] UKUT 341 (TCC). The clinic cannot give you tax advice about your own affairs.