By completing this form you (the patient) consent to being contacted by Ritchie Street Group Practice by the methods you choose below.
The information submitted below will be held in our on-line system for up to 28 days before being deleted. However, a copy will be made and securely stored by the practice to record your consent being given. If you wish to withdraw this consent at any point, please contact the practice.
Information submitted through secure forms is used only for the purposes of processing your request. We may
be in touch with you in relation to the information submitted.
All Information submitted through secure forms is secured with a private key known only to the GP practice and is
accessed over a secure connection by nominated Practice staff. Our practice has a strict confidentiality policy.
This information is not shared with any third party organisations.