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British Society of Paediatric & Adolescent Gynaecology (BritSPAG) Map of Services
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UK Region  *
Hospital Name  *
NHS Trust (If Known) 
Service Type *
Organisation of Clinic *
PAG Lead Consultant *
If Yes - PAG Lead Consultant Name 
If Yes - PAG Lead Consultant Email Address (optional) 
Multidisciplinary Clinic  *
MDT Members *
Yes
No
Paediatrician/Endocrinologist
Paediatric Surgical Doctors
Psychologist/Clinical Psychology
Specialist PAG Nurse
Paediatric Nurse and/or Paediatric HCA
Radiologist (via email/MDT meeting)
Location of PAG Clinic *
Surgical Treatment Services *
Yes
No
Day Surgery Provision
Adolescent Laparoscopy <16YO
Adolescent Gynaecology <14YO
Complex Congenital DSD Surgery
Medical/non-surgical Treatment Services  *
Yes
No
Contraception/Hormonal
HRT
Fertility Preservation (Egg Preservation)
Eating Disorders
Vaginal Dilation Therapy
Precocious Puberty
Imaging Modalities Available *
Yes
No
Ultrasound
MRI
Links with other PAG clinics/units/services *
Yes
No
For Referrals
For Teaching
If Yes/Links to other Units, which Unit/Hospital? 
Availability of RCOG PAG Advanced Training Module (ATSM/SITM) *
Positive Aspects of your PAG Clinic
Negative Aspects/Challenges of your PAG Clinic
Recommendations to improve your PAG services
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