Mid Downs Medical Practice
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Home
Language
Opening Hours
Staff
News
Contact Us
Menu
Appointments
Covid-19
Online Forms
Patient Record
Services
Prescriptions
Join The Practice
Self Help & Wellbeing
Patient Participation Group
Text Reminder Consent Form
Last Updated: 25/09/2019
Your Details
Name
*
Date of Birth
*
Mobile Number
*
Email Address
*
THIS FORM COLLECTS YOUR NAME, DATE OF BIRTH, EMAIL, OTHER PERSONAL INFORMATION. THIS IS TO CONFIRM YOU ARE REGISTERED WITH THE PRACTICE, TO ALLOW THE PRACTICE TEAM TO CONTACT YOU. PLEASE READ OUR PRIVACY POLICY TO DISCOVER HOW WE PROTECT AND MANAGE YOUR SUBMITTED DATA.
*
I consent to the practice collecting and storing my data from this form.
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Further Information
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Minor Injuries - Walk-in Centres
The Good Neighbours Scheme
GDPR and Privacy
GP Earnings
Online Services - Patient Access
Pregnancy Care Planner
Named Accountable GP
Practice Policies
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