Frequently Asked Questions (FAQs)

Online dermatology, also known as ‘teledermatology’ is a type of service that harnesses modern technology to deliver expert skincare remotely. Teledermatology has been around for decades but recently has seen a huge increase in usage across the World. Since dermatology is primarily based upon what you can see, it is perfectly suited to this with very little difference seen compared to care delivered in a physical face-to-face clinic.

Online dermatology has been shown to be as effective as in-person dermatology in over 90% of cases. Skindoc has worked very hard to make sure that its services give you plenty of opportunities to tell us how you need our help, whether it be by using questionnaires, photographs or live video consultations. As a result, skindoc can safely address the vast majority of dermatological issues. It is however not a replacement for in-person dermatology, rather a highly convenient and much more accessible option that removes the need to travel or even leave your own home.

There are still some things that normally need to be seen by a dermatologist in person. This includes, but is not limited to, concerning moles, life-threatening skin rashes, treatment-resistant skin complaints that require immunosuppression etc.

Dermatologists are specialists that are trained in treating disease of the skin, hair, nails and mouth. There are around 2000 different conditions and we can address nearly all of them. Because dermatology can be very confusing, skindoc have created nine easy categories for you to choose from. Please see the ‘What we treat’ section for further information.

Yes. 100% of our services are delivered by UK-based dermatology Consultants. Whichever service you chose, rest assured your concerns will be addressed by a highly qualified skin specialist that fully understands the UK health system.

Yes. Our services are delivered by UK-based dermatology Consultants only.

You can submit photo upload cases and book an online consultation 24/7.

The availability of our doctors will be determined by each individual doctors booking calendar but availability is typically between 8am - 8pm every day of the week.

Our clinical support team are available between the hours of 8am - 8pm every day of the week.

Even though skindoc is a UK-based service, you can book appointments and submit cases from anywhere in the World. Since you will be reviewed by a UK-based doctor, our services follow UK laws and regulations and as such there are some countries you cannot use our service from because their rules and regulations vary. You will not be able to use our services from the following countries: USA, Canada, Australia, New Zealand, South Africa, Germany & China. Before booking, please check for any local restrictions on consulting with a clinician outside of the country you are situated in.

When it comes to prescriptions, there are some European countries where we might be able to submit a private prescription. Please let your doctor know during your appointment if you are outside of the UK so they can best advise you.

If you are a self-funded and self-referred individual, then yes and the prices are available under ‘Pricing’.

If you have private medical insurance, please check with your insurer that they will fund your consultation before booking. Skindoc and the doctors who work here are recognised by several healthcare insurance providers so when you contact them, please ensure that they provide us with your Insurance Membership Policy number and Authorisation Code prior to booking an appointment.

If you have been referred by your NHS GP, then an account will be created for you and payment will not be required.

We will do everything we can to rectify any issues you may have experienced however if you would like to make a formal complaint, please contact us directly at [email protected]. Additionally, when you log in to your account there is a downloadable leaflet in the Resources section which outlines the process and your options.

Your photographs are uploaded to an ultra-secure cloud server situated right here in the UK. An encrypted link is established between this server and skindoc allowing for only you and our clinical team to view them. Your photographs will not be shared with anyone, not even your GP.

Our systems are also protected by state-of-the art cloudflare technology.

Your information can only be shared with your GP with your consent. You can add or update your GP details in the ‘Profile’ section after you login. If no details are provided, we may reach out and ask you what you would like us to do.

If you are claiming through your medical insurance provider then you will need to liaise with them.

We will never share your medical information with your employer and any third-party company.

Yes. When you log in to your account you can delete your account via the 'Profile' section.

Please note, skindoc will erase your account in accordance with GDPR and the Data Protection Act (2018), as well as guidance provided by the Information Commission Officer (ico). We will however keep your medical records in accordance with our Privacy Policy, which follows guidance from the Department of Health and the ico.

Any data held will not be passed to any other third-party organisation and will be stored securely, with strict confidentiality and data security provisions applicable at all times.

We will erase any data that is not necessary for the retention of your medical record.

You will be presented with nine different options relating to differing dermatological issues. You should choose the category that most represents your dermatological issue, even if you have more than one.

Each category has a unique and comprehensive questionnaire that has been specifically designed to obtain the same information that a dermatologist would typically ask you in a clinic.

Afterward, you will be provided a space to upload photographs of your skin issue. When you log in to your account there are guides available via the Resources section on how to make sure you take good quality photos. Remember, the better the photos the more the doctor can help you.

With your questionnaire answers and photographs, a consultant dermatologist should be able to address your case, create a clinical letter and arrange a prescription if needed. They can also provide you with additional education material.

Occasionally more information is required, and your doctor will reach out to you. Don’t worry, this does not cost extra.

Unfortunately, skindoc is founded on the notion that most people have access to the internet and a camera, whether it be a digital camera or smartphone. Since our doctors need to see what your dermatological complaint looks like, skindoc may not be the best service for you. We would therefore suggest seeking a dermatologist in physical clinic.

The main reason this occurs is because the photos submitted were not of a high enough quality for the doctor to be able to use. Other reasons include blurred photos or issues with photos being too light or too dark. If this is the case, your doctor will reach out to you and request additional photographs. Don’t worry, this does not cost extra.

When you log in to your account there are guides available via the Resources section on how to make sure your photos are of good quality.

The photo upload service costs less than the live consultation and is best suited for minor skin ailments that need a quick answer. It remains a safe and reliable option, it is just not as comprehensive or as accurate as live consultations and may provide you with slightly less information.

The live consultations allow you to speak to an expert directly, ask questions and establish a dialogue. Live consultations also permit greater access going forward, especially if further investigations are required.

Your video consultation will be held online via a video conferencing platform just like Zoom or MS Teams, except you do not need to register or create an account. You will be sent a link to it and will be able to access it on your personal computer (PC), laptop, tablet, or smartphone. It's super easy.

You can click the link anytime, but we would advise doing so a few minutes before your appointment is due to check everything is working for you and to get comfortable.

When you click the link, you enter a virtual ‘waiting room’ where you will be held until the doctor is ready to see you. Don’t worry, you may feel like you are all alone, but your doctor will know that you are waiting.

When your doctor begins the video call, expect them to check your ID so please have it ready. All you need to do is hold it up to the camera and the doctor will check it against our records.

Assuming all is well, you and your doctor can start addressing your skin concerns. You have a generous 30 minutes so take your time explaining what has been happening with your skin.

At the end of your consultation, your doctor will guide you through the next steps.

Depending on the time of day that you book, you can usually get an appointment on the same day, if not the next. Very rarely will there be no availability past 48 hours.

Some skindoc doctors are available in the evening, at weekends and even bank holidays.

Yes. If you would like another person to join you, please contact us with their name and email address and our administrative team will arrange a link to be sent to them. It is worth noting, that anybody can join, no matter where they are in the World.

Your appointment is 30 minutes long. If you feel your appointment will take longer than 30 minutes, we advise booking an extra slot. This can be done via your skindoc account or by contacting us.

Yes. Your video consultation will be completely confidential and will not be recorded by either the doctor, the skindoc team or by the video conferencing platform. No personal details will be stored on the platform either.

The video link we send you is encrypted so the only people who can see you will be the doctor and any family or carers you have asked to attend.

Your doctor will be in a private room but please ensure that you have a suitable place to join your appointment where you can talk freely and uninterrupted.

No. The link we send you is specific to you and does not require any additional sign up or password. The link is all you need, and we will send it to your registered email address with the option to add a reminder (with the link attached) to you email or smartphone calendar.

You will not need to download any additional software or register with a new account to use our video service; this includes not needing to download any new apps.

All you need is an internet connection and a smartphone, tablet, laptop or PC with an internet browser like Google Chrome, Mozilla Firefox, Microsoft Edge or Apple iOS Safari.

Yes. Please see our Accessibility page for more information. If you cannot find what you need, please contact us by emailing [email protected]

When you log in to your account there is a section called Resources. This webpage contains all you need to prepare yourself, including a dedicated guide titled: ‘How to prepare for a Live Video Consultation’. This webpage has several other documents that you may find helpful.

Yes. When you sign up and book an appointment you will be prompted to upload some photographs of your dermatology complaint. Your doctor will receive these photos as well as any other written information you choose to share with us.

When you log in to your account there is a section called Resources. This contains several useful documents including two on how to take good photographs. After all, the better the photographs, the easier it is for the doctor to help you.

If you are running late, please contact us as soon as you can via the phone number provided in the Contact us section. We will speak to the doctor and see what can be done.

Occasionally, the doctor will have availability later in the day but if not we may need to re-arrange the appointment to a different day.

Occasionally, the appointment before yours may run over time but it is rarely more than a few minutes so simply stay online in the virtual ‘waiting room’ until you are seen.

If the doctor is running more than 5-10 minutes late, then please do contact us via the phone number provided in the Contact us section. We will check on the status of the doctor and let you know.

If your appointment starts late, don't worry you will still receive the full-time allowance for your appointment.

If you are experiencing connection issues with your WiFi including video lagging, freezing screen, poor quality sound, or video disconnections, try moving your device closer to the WiFi router.

If it’s the mobile data that is the issue, try moving to a better area of reception e.g. near a window or go to the top floor of your property.

Our doctors are all situated in high-connectivity areas.

Firstly, don’t panic. You will still receive your full consultation no matter what, there just may be a delay while we fix this issue. Here is what you should do:

Step 1: When you have opened the video link, if prompted, chose ‘accept’ or ‘grant permission’ for Jitsi™ (the video platform) to use your camera and microphone. If this does not work, try step 2.

Step 2: If you are using a PC/laptop with Windows, open ‘Settings’, choose ‘Privacy’, then choose ‘Microphone’ and check that it is enabled (toggle is set to On for ‘Let apps use my microphone’). If you are experiencing video issues as well, do the same for ‘Camera’. If this does not work, try step 3.

Step 3: If you get the message ‘Error obtaining microphone permission’, open the web browser (e.g. Chrome, Firefox, Microsoft Edge etc.) settings and check the ‘Permissions’ are set to allow the use of your camera and microphone. You will need to refresh the video page after you save the settings. Here are guides on how to do this for each browser: Chrome, Firefox & Microsoft Edge. If this does not work, try step 4.

Step 4: Call us. If steps 1-3 have not worked, please contact us on 07799162976. It is likely we will need to create an emergency link using Microsoft™ Teams or Zoom™ which takes a few minutes to set up.

At present, we are unable to provide a chaperone on the video call however the doctor will be happy for you to bring a family member, friend, or carer in on the call if that would make your experience more comfortable.

You will also have the ability to turn off your camera if you need to expose a body site temporarily and need time to prepare.

If you need to cancel or re-schedule your appointment, please contact us via email or telephone; we will require a minimum of 24 hours’ notice.

If you are unable to make contact, please leave a message on our answer phone, stating your name, as well as date and time of the booked appointment. Any appointments, which are not attended, or are cancelled/re-scheduled with less than 24 hours’ notice, will incur a full charge as the doctor will have already been booked and their time allocated to you.

If you miss your appointment, please contact us to rearrange a more convenient time for your appointment, however, please be aware that unattended appointments will incur a full charge.

If you are an NHS patient, your GP will be informed, and they will need to make another referral for you if you still require one.

A doctor will normally suggest a face-to-face appointment prior to accepting your case for review. If not, this may become apparent after more information has been divulged during a consultation. In both cases your doctor should provide guidance on where, why and how urgently you need to be seen.

Unfortunately, it is our policy that all under 16-year-olds must attend with their parent or legal guardian/carer. If you attend alone or with another person not legally responsible for your wellbeing, the consultation will not go ahead.

A 'follow up' refers to your next appointment. These are booked in the same way as your initial consultation and the system will automatically recognise you as a returning patient as long as it is within three months from your last appointment.

Follow up's are typically suggested to review a response to treatment, ammend dosage and/or medication, review potential side effects and changes in your circumstance that may impact your management. Since they are typically quicker than your initial appointment we reduce the price of these for you as long as it is with the same doctor.

The service works similarly to the live consultation option (see FAQs above) but with added extras. Booking a consultation with one of our doctors will give you full access to everything that skindoc can offer including 30 minutes 1:1 care with your Dermatologist, informational material, personalised clinical letters, a prescription, and extended-hours administrative support.

Isotretinoin (Roaccutane) is however a highly regulated medicine that requires regular appointments over a period of approximately 5-6 months. It also requires strict blood and pregnancy monitoring as well as very careful calculations on medication dosing. As such, we need to keep in close contact with you.

Isotretinoin (Roaccutane) is also associated with several possible side effects so please read all the available information on this medication before booking in. This can be found via the links available under Pricing.

A treatment course involves 3-6 appointments, 2-3 blood tests, monthly pregnancy tests for women and daily treatment with medication. See the next FAQ for a more detailed breakdown of each.

Appointments:

Most people require the initial appointment and then approximately 3-6 follow up appointments (on average 5-6 for women, 3-4 for men)* but this number can be reduced in certain circumstances.

A typical full treatment takes on average, 5-6 months to complete. A new appointment is priced at £170 and each subsequent follow-up appointment is at the reduced price of £130.

Blood Tests:

Assuming you tolerate the medication we normally require blood tests at the start (pre-treatment), another after six weeks and then only every three months thereafter. Additional blood tests may be required with escalating dose changes.

There are a few ways in which to acquire blood tests:

1. Via your GP - with your permission we can send them a request for a Full Blood Count (FBC), Liver Function Test (LFT) and a Fasting Lipid Profile (LP). If they are OK with it, you would need to book in for these tests and ask that your GP forward the results to you or us.
    
2. Home Blood Test Kits (over 18 years old only) - There are several companies online that provide kits, but they vary and do not always contain the correct blood tests required to properly monitor Isotretinoin. Fortunately, we have done all the research for you and have negotiated the cheapest price in the UK with a company called Forth (https://www.forthwithlife.co.uk). They are not part of skindoc but have agreed to provide kits at the reduced price of £75 each for all our patients! With your permission we can order the kit for you, apply payment to your card and arrange for it to be sent to your chosen address.
   
   Unless you request otherwise your doctor can also access your blood test results, check them, and upload them to your skindoc account. If you prefer to order and manage your blood tests yourself the total should be £80.
   
   Please note, they also offer a service whereby a healthcare worker can physically come to your home to do the blood test for an additional £55.
    
3. Private Clinic/Hospital - You may decide to book in with a local private service and have a healthcare professional take your blood. This is the traditional method but is also 2-3x more expensive with a typical set of blood tests costing £200-300 each

Pregnancy Tests (women of child-bearing potential only):

FREE! Skindoc do not believe women should have to pay extra, so we send you a pack with everything you need.

Medication:

We are connected to an amazing online Pharmacy called Phlo (https://wearephlo.com). They are not part of skindoc, but they handle the majority of our prescriptions and have one of the lowest prices for isotretinoin in the UK. They also deliver your medication directly to you! Please note, that high doses are usually more expensive as more tablets are required, but the average is £25-100 per month.

A quick summary of costs would be:

• Initial appointment: £170
• Follow appointments: £130 (x5 on average i.e. usually monthly)
• Blood tests: Free via GP or approx. £225-300 privately (price based on 3-4x home test kits)
• Pregnancy tests: Free (if applicable)
• Medication:  Approximately £25-100 per month (depending on the pharmacy) (5-6 months is the average for a complete course)

Costs vary depending on how many appointments you need, if you get blood tests done privately, your dose of medication and which pharmacy you use but all in all a rough estimate for a six month course of 1:1 Consultant-led treatment for a woman is in the region of £1100-1500 and £1000-1200 for men. Please note treatment courses for other conditions such as rosacea, folliculitis etc. can often last over six months.

*The reason women require more appointment is due to strict monitoring and pregnancy prevention, as dictated by guidance produced by the British Association of Dermatologists. Isotretinoin is a highly regulated medication, and we must abide by this guidance.

If you are a self-referrer then yes, we need you to verify your identity before you can book an appointment.

If you have been referred into our service via your GP, then you will not need to verify your ID as it would have already been checked by them when you joined the practice.

We work closely with the Care Quality Commission, who independently regulate all healthcare providers in the UK. Our identity verification process reflects their recommendations and help us ensure that our service is safe, secure, and effective.

To verify your identity, or the identity of a family member, we ask you to submit relevant identity documentation (ID). We accept valid passports, driving licenses and national identity cards for adults. We will also ask you to confirm parental responsibility for any children under the age of 18. You can do this by uploading a copy of a valid birth certificate or order of guardianship on the child’s behalf.

Alongside the ID we will also require a selfie to compare and check the two match. Once submitted, you are free to use the skindoc platform and we will aim to verify your ID within 24 hours.

You can view your verification status from your skindoc profile.

For safety reasons we cannot accept electronically scanned documents. This is because scans can be tampered with and it's very difficult to recognise forgeries. Instead, please take a photograph of the original ID, making sure you capture the whole document in a crisp, clear image with no cropping.

You can verify your identity at any stage, but we strongly encourage you to do it as soon as you register. We will not be able to help you until your ID has been checked and verified.

Our team will check your documents when you have submitted them. As long as there are no issues, they will verify your account. You can check your status via your skindoc profile.

Please note, we do not permanently store your ID documents anywhere on our system. Once verification is complete, they will be irreversible erased.

Yes, you will need to provide proof of guardianship for any patient under the age of 18. We can accept the following documentation as proof of guardianship:

• Birth Certificate
• Letter of Guardianship
• Copy of your child's passport

We aim to complete the verification process within 24 hours. We recommend that you upload the documents as soon as possible to avoid any delays.

Unfortunately, we will not be able to help you until your ID has been checked and verified.

A blood test may be needed before medication can be prescribed or to monitor you on treatment. You have three options:

1. Blood tests can be arranged via your GP. We can ask them on your behalf if you wish but please note that his can take time and your GP is under no obligation to accept the request. (Free)
2. Home blood test kits can be mailed to you. They are a convenient and affordable option but please be aware there is a small chance of failure and so they may not yield results. These kits are for over 18-year-olds only. (£)
3. Blood tests can be arranged via a private unit. All you need to do is contact a local blood test clinic/hospital in your area. We can provide guidance on which blood tests you need but we cannot book or pay for the tests for you. (£££)

We have negotiated one of the cheapest prices in the UK for home blood test kits with a company called Forth. They have agreed to provide kits at a reduced price for all our patients. With your permission we can order the test for you and arrange for it to be sent to an address of your choosing. Unless you request otherwise, we will also be able to access your blood test results, check them, and upload them to your skindoc account. 

The kits use a small device to draw blood via a finger prick. It is a well-tolerated and minimally uncomfortable process. If however, you do not like the idea of doing it yourself, Forth offer a service whereby you can visit a designated clinic near you and have a healthcare worker do the blood test for you (nb this service requires a small additional cost). You can search the available clinics here.

If you do not want to use Forth, then there are several other companies available to choose from but these are our favourites:

• https://vitall.co.uk
• https://medichecks.com
• https://www.bluecrestwellness.com

Not all blood tests can be performed via a home blood test kits but those that are available include: Cortisol, Creatine Kinase, CRP, Female Hormones¹, Hormone DHEA-Sulphate, Free Androgen Index², Free Testosterone³, Ferritin, Full Blood Count, HbA1c, Kidney Function, Lipid Panel, Liver Function, Magnesium, Omega 3 & 6, Thyroid Function, Thyroglobulin Antibodies, Thyroid Peroxidase Antibodies, Vitamin D & Vitamin B12

¹ includes Follicle Stimulating (FH), Luteinising Hormone (LH), Prolactin & Oestradiol. Progesterone can also be added

² includes Free Androgen Index & Sex Hormone Binding Globulin (SHBG)

³ includes Albumin, Sex Hormone Binding Globulin (SHBG), Testosterone (total) & Free Testosterone (calculated)

Whichever company you choose to for the blood test kit, that company will send you a kit in the post to your chosen address with instructions on how to do the blood test at home and where to return it to for analysis.

All companies currently use a 'finger-prick' type kit. These are an affordable and convenient method but please we aware they sometimes do not work and a repeat kit may be required (nb the first repeat kit is often provided free of charge but this is at the providers discretion).

A typical turnaround time is about a week (two days to deliver the kit, two days to return of the kit and two days to analyse the blood and produce a report).

Rarely, the home blood test kits fail (or partially fail). The typical reasons for this include:

• Underfilled tubes
• Clotting of the blood due to excessive time taken to fill the tubes
• Exposing the kit to extreme conditions e.g. leaving it in a postbox all weekend in low temperatures

That being said, sometimes it is just bad luck.

The lab report the rate of failure to be less than 8% but from our experience it is lower than this.

If one or more of the tests does fail, Forth labs should reach out to you directly and offer a second (repeat) test free of charge.

So, overall the home blood test kits offer an affordable, rapid and low risk option for you.

Yes. All services provided by skindoc allow for a prescription to be generated. We have partnered up with two great online pharmacists Phlo and Simple who can arrange delivery of you medicines within hours if you live in London or the following day for anywhere else in the UK.

You are under no obligation to use either and so if you would prefer not to, you can simply provide a copy of your prescription to your GP along with your clinical letter and request they prescribe it for you. Please note, that there are several medicines that GPs are not authorised to prescribe e.g. Isotretinoin. Furthermore, most UK pharmacists do not accept digital prescriptions yet and so online pharmacists tend to be easier.

It is important to be aware that our doctors will not prescribe controlled drugs and some high-risk medicines. We may refuse to prescribe to you have any safety or legal concerns.

Please note that the service prices quoted by skindoc do not include cost of prescription nor the delivery charge.

Yes, however in order to obtain a repeat supply of medicines a consultation must be booked, this includes for urgent prescriptions.

This depends on where you choose to obtain your medicines from. If you use our partner pharmacy Phlo they can arrange delivery of you medicines within hours if you live in certain cities such as London & Birmingham. Otherwise, both Phlo and Simple Pharmacy offer next day and other delivery options.

All other methods will likely entail a delay, especially if the medication is uncommonly used or high-risk.

We do not deliver prescriptions outside the UK.

Your prescription will expire 28 days after you receive your documents. If you have not collected your prescription within this time, you will be required to book another consultation to have your medication re-prescribed again.

The only exception to this is for isotretinoin prescriptions for females. These are only valid for seven days.

Phlo will contact you directly to organise payment and delivery. If you chose not to use Phlo, then you would need to contact your chosen pharmacy directly.

Please allow 1-3 days if your prescription is being sent via post however if nothing has been received after that then please contact us at [email protected]. and let us know which pharmacy you are using. We will chase this up with them directly.

If you are using the online pharmacy, Phlo, then please allow 24 hours to be contacted. If f nothing has been received with this time period then please contact us at [email protected].

We can email you a copy of your prescription and it can also be downloaded from your skindoc account. However this just functions as documentation for your records and cannot be printed and used in a pharmacy. This is because prescriptions in the UK are only valid in two forms:

1. Encrypted and digitally-signed sent directly to a pharmacy
2. Paper prescriptions hand-signed by a doctor

Emailed and printed prescriptions would not cover either form.

Yes, but only if we have an agreement with that pharmacy. We are increasing our network of partner pharmacies but are concentrating on larger providers rather than individual pharmcies. As such our primary relationship is with Phlo Pharmacy who we have a direct relationship with. This allows us to send prescriptions to them instantaneously. 

Yes. It is fairly common for patients to require some tests e.g. blood test, swabs, biopsies etc. If this is the case the letter your doctor writes for you will contain the necessary information and where to seek attention from.

If you decide to go privately, the private healthcare provider you choose will send you the results of your exam or test.

If you decide to seek investigations via your GP, you will need to ask them for a copy of the results and send them to us when available.

Part of the service we provide includes interpretation and advice on results of investigations that we suggested. Any investigations that relate to your case can be forwarded to us and uploaded to your file. As long as your case is still relatively fresh, we will ask your doctor to relay further advice. Simply email us at [email protected] with your name, date of birth and case ID number (available on your clinic letter and/or prescription) and attach copies of the investigations you had performed.

If you require an onward referral your doctor will generate a letter for you. You can use the letter to organise your next appointment. In the private sector, this is relatively straightforward but if you ask your GP to refer you into the NHS you may experience some resistance not to mention long waiting times.

If you have private health insurance, speak to your insurer before you book your next appointment. You will need to check if the referral is covered under your policy with them.

Unfortunately not. You can self-certify for seven days, after that you will need to discuss this with your GP.

Just like in traditional dermatology clinics, a diagnosis may not always be possible at the first appointment or photo upload submission. The doctor may suggest that further investigations are required, many of which can occur via your GP e.g. blood tests, skin swabs and urine analysis. Occasionally, specialist tests are required e.g. a skin biopsy. Your doctor will inform you of what tests may be needed and it would be your decision if you want to obtain them privately or via the NHS.

When registering with skindoc you will be given the opportunity to enter your GPs details. If you do provide them our administrative team will assume that you are happy for us to share correspondence with your GP. If however you would prefer us not share specific information then please contact us in advance of your submission or booking.