To be completed by an authorised member of the practice
You can use your Practice Code or Surgery name to search for your Surgery, but if any information is incorrect please feel free to overwrite with the correct details.
Please provide a central contact email for the Surgery, where all instructions and notifications will be sent (in addition to notification choices of the individual users)
These will appear in a pop-up, so please make sure any pop-up blockers are disabled temporarily to enable this.
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The terms and conditions are not accepted. You can proceed but you will not be able to receive or initiate instructions until reviewed and accepted