Request to rearrange a consultation
Please rearrange the following consultation. I understand that I must give you at least 1 full working day's (24 hrs) notice.
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Email *
My Name *
My Phone No *
My Practitioner *
My Programme *
The date of the consultation I need to rearrange *
MM
/
DD
/
YYYY
The time of the consultation I need to rearrange *
Time
:
A copy of your responses will be emailed to the address you provided.
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