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* 1. Which services would you like to see in our extended hours? ( you can click more than one)

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* 2. For the above services when would you prefer these services to be offered?

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* 3. Would you be open to going to a different Practice for these services?

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* 4. I would prefer my extended hours GP appointments to be...

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* 5. What is you Ethnicity?

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* 6. Please select your age

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