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*** PLEASE DO NOT USE THIS CONTACT FORM FOR REQUESTS FOR MEDICATION, LETTERS or SICK NOTES. IT ALSO CANNOT BE USED TO REQUEST AN APPOINTMENT OR FOR MEDICAL QUERIES. THERE ARE OTHER FORMS ON OUR WEBSITE FOR MEDICAL QUERIES AND FOR REQUESTS RELATED TO MEDICATION AND LETTERS. ANY REQUESTS FOR THE ABOVE MADE USING THIS FORM MAY NOT BE ANSWERED ***

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This form collects personal and medical informanot tion 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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