Colliers Wood & Lavender Fields

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Patient Complaint Form

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Are you happy with the current buildings at Lavender Fields and Colliers Wood Surgery?

Do you think that the current buildings are fit for their purpose?

Would you prefer for the practice to a single modern purpose built site?

About You

What is your age? *

Are you;

What is your postcode?

If you have any comments, please feel free to write the here:

We thank you very much for your time and opinion.

Dr Ayub and Dr Ahmad

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