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Accessibility Needs

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All questions marked with a * are mandatory

Personal Details

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May be used to identify you

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Accessibility Questions

Do you have any accessibility needs to help you read our letters and/or mobile communications?: *

Do you need information in braille, large print or easy read?: *

Do you need a British Sign Language interpreter or advocate for any appointments?: *

Do you need support to lipread or use a hearing aid or communication tool?: *

Do you have any special communication requirements?: *

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Privacy Consent

This form collects personal and medical information about you and 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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Providing NHS Services

Pound House Surgery
8 The Green
Wooburn Green
Buckinghamshire
HP10 0EE

Telephone: 01628 530 997

Hawthornden Surgery
Wharf Lane
Bourne End
Buckinghamshire
SL8 5RX

Telephone: 01628 530 997

The Orchard Surgery
Station Road
Bourne End
Buckinghamshire
SL8 5QE

Telephone: 01628 530 997