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Liz Ettridge, has spent 54 years working for the NHS and shares her 70th birthday this year with the NHS. She...... Read more »
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This form is secure and the information you provide is confidential. Our team will receive the details you enter and only use it for the purposes of your request.

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Patient details
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GP details
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(if known)

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A limited number of places are available on specially equipped ambulances for people unable to make their own arrangements to attend the centre. Please indicate below whether transport will be required after all alternatives have been explored.

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You will see a thank you page once the form has been submitted. If you do not see this page then you have overlooked to complete some of the required fields. Please check the form, complete the missing details and resubmit. Thank you.

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