Consent

Please score the consultation that you have had with Mr George Ampat. This survey is to improve the services provided by Mr George Ampat and also to help other patients who may want to have an Orthopaedic / Spinal consultation with Mr Ampat. Please note that the overall results will be published on the internet or other media. 

* 1. I have read the above statement and consent to the overall results to be published on the internet and other media.

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