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Physiotherapy & Sport Rehabilitation - Booking Form

Please fill out the details below:

    Your details

Details of your injury

Data protection

In accordance with the Data Protection Act (1998) your permission is required for the collection and retention of any personal data. Information kept within the Physiotherapy Clinic consists of personal details (above), appointment records and written notes which are kept in a secure place and destroyed after 7 years.

Research and marketing

The Faculty of Health Studies at the University of Bradford may in future contact you with news of upcoming events and developments which may be of interest to you.

As a teaching facility your details may be used (anonymously) for research purposes in future,
I consent: