Lawton House Surgery
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Home
Language
Contact us
Opening Hours
Menu
About the Practice
Appointments
COVID-19
Prescriptions
Emergencies
eConsult
Patient Record
Our Services
New Patients
Integration of Health & Social Care
Wellbeing
News
Your Data
Text Reminder Consent Form
Last Updated: 25/09/2019
Your Details
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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.
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I consent to the practice collecting and storing my data from this form.
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