Communication Consent Form

 

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Please complete our online form

Your submission will not get looked at until the next working day of the surgery.

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Personal Details
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Patient Consent

We need to have your consent to begin communicating with you by text or email. Please tick to accept in the boxes below.

Privacy Consent

This form collects personal and medical information about you. We use this information to allow the practice team to contact you. Please read our Privacy Policy to discover how we protect and manage your submitted data.

 
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