Feedback Questionnaire

 
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On a scale of 1 to 5 (1 lowest, 5 the highest)

Have you used our ‘main’ online consultation system, eConsult, before?: *
Did you?: *

Privacy Consent

This form is designed to be colelct anonymous feedback, but may collect personal and medical information about you if you enter such data into the form. We would use this information to allow the practice team to contact you regarding your feedback. Please read our Privacy Policy to discover how we protect and manage your submitted data.

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