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Contact us, feedback or register
          
      Please use this form in order to
      1.   let us know you are happy to accept clients who are not
            registered patients or
      2.   inform us of any queries, comments or suggestions.


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  *Title:
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  *Firstname:
  Address 1:
  Address 2:
  Town:
  County:
  Postcode:
  *email:
  Register me:  Yes, I want to accept un-registered patients
  Comments:

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