The more clearly you describe your concern, the easier it is for the provider to follow up. Useful details include what you have noticed, roughly when it started, and what you would like to ask. You do not need to share medical history here. That can wait for the consultation.
Tick the consent box so the provider may contact you by phone, text or email about your request.
If you change your mind
Sent a request and now having second thoughts? That is fine. When the provider contacts you, tell them you do not want to go ahead. You can also withdraw your consent by writing to the address on the privacy page, or reply STOP to any text message.
Sending the form did not commit you to anything, so there is nothing to cancel.