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    First Name *

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    Used only if you would like us to contact your GP.

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    Do you have any pre-existing medical conditions or concerns that we should be aware of?

    I consent to a verbal history, relevant clinical assessment and, after a report of findings, treatment if deemed necessary *
    We always explain everything before our history, assessment and treatment. We will never do anything without your consent and you can decline or revoke consent at any time.

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    We never share your information with anyone and we only ever contact you with relevant clinical information and treatment advice.