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CLIENT UPDATE FORM

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    Todays Date (required)

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    Your Name and Surname (required)

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    Your Email (required)

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    Mobile Number (required)

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    Has your medication changed? (required)

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    If Yes please provide details here (required)

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    I certify that I have read the entire informed consent and I agree to all its provisions. I certify that I have had the opportunity to ask questions and these questions have been answered to my satisfaction.

    I fully understand the treatment conditions and procedure.

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    Terms and Conditions

    We want you to know how our service works and why and how we handle your data. Please state that you have read and agreed to these terms and conditions.

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    Contact Permission

    Occasionally we would like to newsletters and offers and the latest info from Sunnyside Skin Clinic by Email, post, SMS and other electronic means. We take your privacy very seriously and will only use your personal infomrmation to administer your account and to provide the services you have requested from us. If you consent to us contacting you for this purpose please tick to say how you would like us to contact you.
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