<EMISWebDocTemplate><DisplayGroups></DisplayGroups><DefaultDocumentType>2548970018</DefaultDocumentType><DocumentTypeCodeSystem>SNOMED_CONCEPT</DocumentTypeCodeSystem><Description>Imported item.</Description><TemplateRtf><![CDATA[{\rtf1\adeflang1025\ansi\ansicpg1252\uc1\adeff1\deff0\stshfdbch0\stshfloch31506\stshfhich31506\stshfbi31506\deflang2057\deflangfe2057\themelang2057\themelangfe0\themelangcs0{\fonttbl{\f0\fbidi \froman\fcharset0\fprq2{\*\panose 00000000000000000000}Times New Roman;}{\f1\fbidi \fswiss\fcharset0\fprq2{\*\panose 00000000000000000000}Arial;}
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{\fdbminor\f31562\fbidi \froman\fcharset162\fprq2 Times New Roman Tur;}{\fdbminor\f31563\fbidi \froman\fcharset177\fprq2 Times New Roman (Hebrew);}{\fdbminor\f31564\fbidi \froman\fcharset178\fprq2 Times New Roman (Arabic);}
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\sectdefaultcl\sftnbj {\rtlch\fcs1 \af1\afs18 \ltrch\fcs0 \b\f161\fs18\insrsid6580284 {\*\bkmkend Oo8evEkhwjB8LNdLZoH1} 
\par }{\field\fldedit{\*\fldinst {\rtlch\fcs1 \af1\afs18 \ltrch\fcs0 \b\f161\fs18\insrsid6580284 {\*\bkmkstart OcQvIj2jNRKXKAMHDR5e} FORMTEXT }{\rtlch\fcs1 \af1\afs18 \ltrch\fcs0 \b\f161\fs18\insrsid6580284 {\*\datafield 
0002000014000000144f635176496a326a4e524b584b414d484452356500000000000000000000000000}{\*\formfield{\fftype0\ffprot\fftypetxt0\ffhps20{\*\ffname OcQvIj2jNRKXKAMHDR5e}}}}}{\fldrslt {\rtlch\fcs1 \af1\afs18 \ltrch\fcs0 \b\f161\fs18\insrsid6580284 
Organisation Full Address (stacked)}}}\sectd \ltrsect\linex0\headery0\footery70\endnhere\pgbrdropt32\pgbrdrt\brdrs\brdrw20\brsp340\brdrcf24 \pgbrdrl\brdrs\brdrw20\brsp340\brdrcf24 \pgbrdrb\brdrs\brdrw20\brsp360\brdrcf24 \pgbrdrr
\brdrs\brdrw20\brsp320\brdrcf24 \sectdefaultcl\sftnbj {\rtlch\fcs1 \af1\afs18 \ltrch\fcs0 \b\f161\fs18\insrsid6580284 {\*\bkmkend OcQvIj2jNRKXKAMHDR5e} \cell }\pard\plain \ltrpar
\ql \li0\ri0\nowidctlpar\intbl\wrapdefault\aspalpha\aspnum\faauto\adjustright\rin0\lin0 \rtlch\fcs1 \af1\afs22\alang1025 \ltrch\fcs0 \f1\fs22\lang1033\langfe1033\cgrid\langnp1033\langfenp1033 {\rtlch\fcs1 \af1\afs18 \ltrch\fcs0 
\b\f161\fs18\insrsid6580284 \trowd \irow0\irowband0\lastrow \ltrrow\ts34\trgaph108\trrh1805\trleft0\trbrdrt\brdrs\brdrw20\brdrcf24 \trbrdrl\brdrs\brdrw20\brdrcf24 \trbrdrb\brdrs\brdrw20\brdrcf24 \trbrdrr\brdrs\brdrw20\brdrcf24 \trbrdrh
\brdrs\brdrw20\brdrcf24 \trbrdrv\brdrs\brdrw20\brdrcf24 \trftsWidth1\trftsWidthB3\trautofit1\trpaddl108\trpaddr108\trpaddfl3\trpaddft3\trpaddfb3\trpaddfr3\tblrsid6580284\tbllkhdrrows\tbllkhdrcols\tbllknocolband\tblind108\tblindtype3 \clvertalt\clbrdrt
\brdrs\brdrw20\brdrcf24 \clbrdrl\brdrs\brdrw20\brdrcf24 \clbrdrb\brdrs\brdrw20\brdrcf24 \clbrdrr\brdrs\brdrw20\brdrcf24 \cltxlrtb\clftsWidth3\clwWidth4111\clshdrawnil \cellx4111\clvertalt\clbrdrt\brdrs\brdrw20\brdrcf24 \clbrdrl\brdrs\brdrw20\brdrcf24 
\clbrdrb\brdrs\brdrw20\brdrcf24 \clbrdrr\brdrs\brdrw20\brdrcf24 \cltxlrtb\clftsWidth3\clwWidth3402\clshdrawnil \cellx7513\row }\pard\plain \ltrpar\s16\ql \li0\ri0\sb3\nowidctlpar\wrapdefault\faauto\adjustright\rin0\lin0\itap0 \rtlch\fcs1 
\af1\afs15\alang1025 \ltrch\fcs0 \f1\fs15\lang1033\langfe1033\cgrid\langnp1033\langfenp1033 {\rtlch\fcs1 \af1\afs18 \ltrch\fcs0 \b\f161\fs18\insrsid4466434 
\par }{\rtlch\fcs1 \af1\afs18 \ltrch\fcs0 \b\f161\fs18\insrsid4466434\charrsid10757343 
\par \ltrrow}\trowd \irow0\irowband0\ltrrow\ts11\trrh-290\trleft142\trbrdrt\brdrs\brdrw30\brdrcf25 \trbrdrl\brdrs\brdrw30\brdrcf25 \trbrdrb\brdrs\brdrw30\brdrcf25 \trbrdrr\brdrs\brdrw30\brdrcf25 \trbrdrh\brdrs\brdrw30\brdrcf25 \trbrdrv\brdrs\brdrw30\brdrcf25 
\trftsWidth1\trftsWidthB3\trpaddfl3\trpaddft3\trpaddfb3\trpaddfr3\tblrsid10757343\tbllkhdrrows\tbllklastrow\tbllkhdrcols\tbllklastcol\tblind142\tblindtype3 \clvertalt\clbrdrt\brdrnone \clbrdrl\brdrnone \clbrdrb\brdrnone \clbrdrr\brdrnone 
\clcbpat25\cltxlrtb\clftsWidth3\clwWidth7493\clcbpatraw25 \cellx7635\pard\plain \ltrpar\s19\qc \li0\ri2698\sb84\nowidctlpar\intbl\wrapdefault\faauto\adjustright\rin2698\lin0\pararsid2251537 \rtlch\fcs1 \af1\afs22\alang1025 \ltrch\fcs0 
\f1\fs22\lang1033\langfe1033\cgrid\langnp1033\langfenp1033 {\rtlch\fcs1 \af1\afs18 \ltrch\fcs0 \b\f161\fs18\cf8\insrsid2580128\charrsid10757343 PATIENT FOR}{\rtlch\fcs1 \af1\afs18 \ltrch\fcs0 
\b\f161\fs18\expnd0\expndtw3\cf8\insrsid2580128\charrsid10757343  }{\rtlch\fcs1 \af1\afs18 \ltrch\fcs0 \b\f161\fs18\cf8\insrsid2580128\charrsid10757343 REFERRAL}{\rtlch\fcs1 \af1\afs18 \ltrch\fcs0 \b\f161\fs18\insrsid344866\charrsid10757343 \cell 
}\pard\plain \ltrpar\ql \li0\ri0\nowidctlpar\intbl\wrapdefault\aspalpha\aspnum\faauto\adjustright\rin0\lin0 \rtlch\fcs1 \af1\afs22\alang1025 \ltrch\fcs0 \f1\fs22\lang1033\langfe1033\cgrid\langnp1033\langfenp1033 {\rtlch\fcs1 \af1\afs18 \ltrch\fcs0 
\f161\fs18\insrsid344866\charrsid10757343 \trowd \irow0\irowband0\ltrrow\ts11\trrh-290\trleft142\trbrdrt\brdrs\brdrw30\brdrcf25 \trbrdrl\brdrs\brdrw30\brdrcf25 \trbrdrb\brdrs\brdrw30\brdrcf25 \trbrdrr\brdrs\brdrw30\brdrcf25 \trbrdrh
\brdrs\brdrw30\brdrcf25 \trbrdrv\brdrs\brdrw30\brdrcf25 \trftsWidth1\trftsWidthB3\trpaddfl3\trpaddft3\trpaddfb3\trpaddfr3\tblrsid10757343\tbllkhdrrows\tbllklastrow\tbllkhdrcols\tbllklastcol\tblind142\tblindtype3 \clvertalt\clbrdrt\brdrnone \clbrdrl
\brdrnone \clbrdrb\brdrnone \clbrdrr\brdrnone \clcbpat25\cltxlrtb\clftsWidth3\clwWidth7493\clcbpatraw25 \cellx7635\row \ltrrow}\trowd \irow1\irowband1\ltrrow\ts11\trrh-1845\trleft142\trbrdrt\brdrs\brdrw30\brdrcf25 \trbrdrl\brdrs\brdrw30\brdrcf25 \trbrdrb
\brdrs\brdrw30\brdrcf25 \trbrdrr\brdrs\brdrw30\brdrcf25 \trbrdrh\brdrs\brdrw30\brdrcf25 \trbrdrv\brdrs\brdrw30\brdrcf25 
\trftsWidth1\trftsWidthB3\trpaddfl3\trpaddft3\trpaddfb3\trpaddfr3\tblrsid10757343\tbllkhdrrows\tbllklastrow\tbllkhdrcols\tbllklastcol\tblind142\tblindtype3 \clvertalt\clbrdrt\brdrnone \clbrdrl\brdrs\brdrw30\brdrcf25 \clbrdrb\brdrs\brdrw30\brdrcf25 
\clbrdrr\brdrs\brdrw30\brdrcf25 \cltxlrtb\clftsWidth3\clwWidth7493\clshdrawnil \cellx7635\pard\plain \ltrpar\s19\ql \li0\ri0\sl276\slmult1\nowidctlpar\intbl\wrapdefault\faauto\adjustright\rin0\lin0\pararsid10819794 \rtlch\fcs1 \af1\afs22\alang1025 
\ltrch\fcs0 \f1\fs22\lang1033\langfe1033\cgrid\langnp1033\langfenp1033 {\rtlch\fcs1 \af1\afs18 \ltrch\fcs0 \b\f161\fs18\cf27\charscalex105\insrsid10819794\charrsid10757343  }{\rtlch\fcs1 \af1\afs18 \ltrch\fcs0 
\b\f161\fs18\cf27\charscalex105\insrsid10757343\charrsid10757343 {\*\bkmkstart Check1}
\par My patient has requested}{\rtlch\fcs1 \af1\afs18 \ltrch\fcs0 \b\f161\fs18\cf27\charscalex105\insrsid12255748 :}{\rtlch\fcs1 \af1\afs18 \ltrch\fcs0 \b\f161\fs18\cf27\charscalex105\insrsid10757343\charrsid10757343 
\par 
\par }{\field\flddirty\fldpriv{\*\fldinst {\rtlch\fcs1 \af1\afs18 \ltrch\fcs0 \b\f161\fs18\cf27\charscalex105\insrsid10819794\charrsid10757343  FORMCHECKBOX }{\rtlch\fcs1 \af1\afs18 \ltrch\fcs0 \b\f161\fs18\cf27\charscalex105\insrsid10819794\charrsid10757343 
{\*\datafield 650000001400000006436865636b3100000000000000000000000000}{\*\formfield{\fftype1\ffres25\fftypetxt0\ffhps20{\*\ffname Check1}\ffdefres0}}}}{\fldrslt }}\sectd \ltrsect\linex0\headery0\footery70\endnhere\pgbrdropt32\pgbrdrt
\brdrs\brdrw20\brsp340\brdrcf24 \pgbrdrl\brdrs\brdrw20\brsp340\brdrcf24 \pgbrdrb\brdrs\brdrw20\brsp360\brdrcf24 \pgbrdrr\brdrs\brdrw20\brsp320\brdrcf24 \sectdefaultcl\sftnbj {\rtlch\fcs1 \af1\afs18 \ltrch\fcs0 
\b\f161\fs18\cf27\charscalex105\insrsid10819794\charrsid10757343 {\*\bkmkend Check1}  }{\rtlch\fcs1 \af1\afs18 \ltrch\fcs0 \b\f161\fs18\cf27\charscalex105\insrsid2580128\charrsid10757343 NHS Treatment - }{\rtlch\fcs1 \af1\afs18 \ltrch\fcs0 
\f161\fs18\cf27\charscalex105\insrsid2580128\charrsid10757343 I am referring this patient under the NHS. The CCG has an agreement to pay for the treatment}{\rtlch\fcs1 \af1\afs18 \ltrch\fcs0 \f161\fs18\cf27\charscalex105\insrsid12255748 .}{\rtlch\fcs1 
\af1\afs18 \ltrch\fcs0 \f161\fs18\insrsid344866\charrsid10757343 
\par }\pard \ltrpar\s19\ql \li0\ri0\sb9\nowidctlpar\intbl\wrapdefault\faauto\adjustright\rin0\lin0 {\rtlch\fcs1 \af1\afs18 \ltrch\fcs0 \b\f161\fs18\insrsid344866\charrsid10757343 
\par }\pard \ltrpar\s19\ql \li59\ri0\nowidctlpar\intbl\wrapdefault\faauto\adjustright\rin0\lin59\pararsid10757343 {\rtlch\fcs1 \af1\afs18 \ltrch\fcs0 \b\f161\fs18\cf27\charscalex105\insrsid2580128\charrsid10757343 CCG Name }{\rtlch\fcs1 \af1\afs18 \ltrch\fcs0 
\f161\fs18\cf27\charscalex105\insrsid2580128\charrsid10757343 (if NHS referral)}{\rtlch\fcs1 \af1\afs18 \ltrch\fcs0 \f161\fs18\cf27\charscalex105\insrsid10819794\charrsid10757343  }{\rtlch\fcs1 \ab\af1\afs18 \ltrch\fcs0 
\b\f161\fs18\cf27\charscalex105\insrsid10757343\charrsid10757343 YORK}{\rtlch\fcs1 \af1\afs18 \ltrch\fcs0 \f161\fs18\cf27\charscalex105\insrsid10757343\charrsid10757343 
\par 
\par }{\rtlch\fcs1 \af1\afs18 \ltrch\fcs0 \f161\fs18\cf27\charscalex105\insrsid2580128\charrsid10757343 (}{\rtlch\fcs1 \af1\afs18 \ltrch\fcs0 \i\f161\fs18\cf27\charscalex105\insrsid2580128\charrsid10757343 
Please check with your CCG if you are unsure about agreements)}{\rtlch\fcs1 \af1\afs18 \ltrch\fcs0 \i\f161\fs18\insrsid344866\charrsid10757343 \cell }\pard\plain \ltrpar
\ql \li0\ri0\nowidctlpar\intbl\wrapdefault\aspalpha\aspnum\faauto\adjustright\rin0\lin0 \rtlch\fcs1 \af1\afs22\alang1025 \ltrch\fcs0 \f1\fs22\lang1033\langfe1033\cgrid\langnp1033\langfenp1033 {\rtlch\fcs1 \af1\afs18 \ltrch\fcs0 
\f161\fs18\insrsid344866\charrsid10757343 \trowd \irow1\irowband1\ltrrow\ts11\trrh-1845\trleft142\trbrdrt\brdrs\brdrw30\brdrcf25 \trbrdrl\brdrs\brdrw30\brdrcf25 \trbrdrb\brdrs\brdrw30\brdrcf25 \trbrdrr\brdrs\brdrw30\brdrcf25 \trbrdrh
\brdrs\brdrw30\brdrcf25 \trbrdrv\brdrs\brdrw30\brdrcf25 \trftsWidth1\trftsWidthB3\trpaddfl3\trpaddft3\trpaddfb3\trpaddfr3\tblrsid10757343\tbllkhdrrows\tbllklastrow\tbllkhdrcols\tbllklastcol\tblind142\tblindtype3 \clvertalt\clbrdrt\brdrnone \clbrdrl
\brdrs\brdrw30\brdrcf25 \clbrdrb\brdrs\brdrw30\brdrcf25 \clbrdrr\brdrs\brdrw30\brdrcf25 \cltxlrtb\clftsWidth3\clwWidth7493\clshdrawnil \cellx7635\row \ltrrow}\trowd \irow2\irowband2\ltrrow\ts11\trrh-2020\trleft142\trbrdrt\brdrs\brdrw30\brdrcf25 \trbrdrl
\brdrs\brdrw30\brdrcf25 \trbrdrb\brdrs\brdrw30\brdrcf25 \trbrdrr\brdrs\brdrw30\brdrcf25 \trbrdrh\brdrs\brdrw30\brdrcf25 \trbrdrv\brdrs\brdrw30\brdrcf25 
\trftsWidth1\trftsWidthB3\trpaddfl3\trpaddft3\trpaddfb3\trpaddfr3\tblrsid5460777\tbllkhdrrows\tbllklastrow\tbllkhdrcols\tbllklastcol\tblind142\tblindtype3 \clvertalt\clbrdrt\brdrs\brdrw30\brdrcf25 \clbrdrl\brdrs\brdrw30\brdrcf25 \clbrdrb
\brdrs\brdrw10\brdrcf25 \clbrdrr\brdrs\brdrw30\brdrcf25 \cltxlrtb\clftsWidth3\clwWidth3969\clshdrawnil \cellx4111\clvertalt\clbrdrt\brdrs\brdrw30\brdrcf25 \clbrdrl\brdrs\brdrw30\brdrcf25 \clbrdrb\brdrs\brdrw10\brdrcf25 \clbrdrr\brdrs\brdrw30\brdrcf25 
\cltxlrtb\clftsWidth3\clwWidth3524\clshdrawnil \cellx7635\pard\plain \ltrpar\s19\ql \li59\ri0\sb76\nowidctlpar\intbl\wrapdefault\faauto\adjustright\rin0\lin59 \rtlch\fcs1 \af1\afs22\alang1025 \ltrch\fcs0 
\f1\fs22\lang1033\langfe1033\cgrid\langnp1033\langfenp1033 {\rtlch\fcs1 \af1\afs18 \ltrch\fcs0 \b\f161\fs18\cf27\insrsid2580128\charrsid10757343 Patient Name and Contact details}{\rtlch\fcs1 \af1\afs18 \ltrch\fcs0 
\b\f161\fs18\insrsid344866\charrsid10757343 
\par }\pard \ltrpar\s19\ql \li68\ri0\sb29\nowidctlpar\intbl\wrapdefault\faauto\adjustright\rin0\lin68\pararsid11423374 {\rtlch\fcs1 \af1\afs18 \ltrch\fcs0 \f161\fs18\cf27\insrsid2580128\charrsid10757343 Title:}{\rtlch\fcs1 \af1\afs18 \ltrch\fcs0 
\f161\fs18\cf27\insrsid10819794\charrsid10757343  {\*\bkmkstart PJnR1LakosHfbsPeQj3V}}{\field\fldedit{\*\fldinst {\rtlch\fcs1 \af1\afs18 \ltrch\fcs0 \f161\fs18\cf27\insrsid10819794\charrsid10757343  FORMTEXT }{\rtlch\fcs1 \af1\afs18 \ltrch\fcs0 
\f161\fs18\cf27\insrsid10819794\charrsid10757343 {\*\datafield 000200001400000014504a6e52314c616b6f73486662735065516a335600000000000000000000000000}{\*\formfield{\fftype0\ffprot\fftypetxt0\ffhps20{\*\ffname PJnR1LakosHfbsPeQj3V}}}}}{\fldrslt {\rtlch\fcs1 
\af1\afs18 \ltrch\fcs0 \f161\fs18\cf27\insrsid10819794\charrsid10757343 Title}}}\sectd \ltrsect\linex0\headery0\footery70\endnhere\pgbrdropt32\pgbrdrt\brdrs\brdrw20\brsp340\brdrcf24 \pgbrdrl\brdrs\brdrw20\brsp340\brdrcf24 \pgbrdrb
\brdrs\brdrw20\brsp360\brdrcf24 \pgbrdrr\brdrs\brdrw20\brsp320\brdrcf24 \sectdefaultcl\sftnbj {\rtlch\fcs1 \af1\afs18 \ltrch\fcs0 \f161\fs18\cf27\insrsid10819794\charrsid10757343 {\*\bkmkend PJnR1LakosHfbsPeQj3V} }{\rtlch\fcs1 \af1\afs18 \ltrch\fcs0 
\f161\fs18\insrsid344866\charrsid10757343 
\par }\pard \ltrpar\s19\ql \li68\ri0\sb26\nowidctlpar\intbl\wrapdefault\faauto\adjustright\rin0\lin68\pararsid11423374 {\field\fldedit{\*\fldinst {\rtlch\fcs1 \ab\af1\afs18 \ltrch\fcs0 \b\f161\fs18\cf27\insrsid15341153\charrsid12255748 
{\*\bkmkstart P8idgleG1ZTIdQJ3a1PI} FORMTEXT }{\rtlch\fcs1 \ab\af1\afs18 \ltrch\fcs0 \b\f161\fs18\cf27\insrsid15341153\charrsid12255748 {\*\datafield 00020000140000001450386964676c6547315a544964514a336131504900000000000000000000000000}
{\*\formfield{\fftype0\ffprot\fftypetxt0\ffhps20{\*\ffname P8idgleG1ZTIdQJ3a1PI}}}}}{\fldrslt {\rtlch\fcs1 \ab\af1\afs18 \ltrch\fcs0 \b\f161\fs18\cf27\insrsid15341153\charrsid12255748 Calling Name}}}\sectd \ltrsect
\linex0\headery0\footery70\endnhere\pgbrdropt32\pgbrdrt\brdrs\brdrw20\brsp340\brdrcf24 \pgbrdrl\brdrs\brdrw20\brsp340\brdrcf24 \pgbrdrb\brdrs\brdrw20\brsp360\brdrcf24 \pgbrdrr\brdrs\brdrw20\brsp320\brdrcf24 \sectdefaultcl\sftnbj {\rtlch\fcs1 
\ab\af1\afs18 \ltrch\fcs0 \b\f161\fs18\cf27\insrsid15341153\charrsid12255748 {\*\bkmkend P8idgleG1ZTIdQJ3a1PI} }{\field\fldedit{\*\fldinst {\rtlch\fcs1 \ab\af1\afs18 \ltrch\fcs0 \b\f161\fs18\cf27\insrsid12133972\charrsid12255748 
{\*\bkmkstart P5pNijd5MpP3a5Ko2dHf} FORMTEXT }{\rtlch\fcs1 \ab\af1\afs18 \ltrch\fcs0 \b\f161\fs18\cf27\insrsid12133972\charrsid12255748 {\*\datafield 0002000014000000145035704e696a64354d70503361354b6f3264486600000000000000000000000000}
{\*\formfield{\fftype0\ffprot\fftypetxt0\ffhps20{\*\ffname P5pNijd5MpP3a5Ko2dHf}}}}}{\fldrslt {\rtlch\fcs1 \ab\af1\afs18 \ltrch\fcs0 \b\f161\fs18\cf27\insrsid12133972\charrsid12255748 Surname}}}\sectd \ltrsect
\linex0\headery0\footery70\endnhere\pgbrdropt32\pgbrdrt\brdrs\brdrw20\brsp340\brdrcf24 \pgbrdrl\brdrs\brdrw20\brsp340\brdrcf24 \pgbrdrb\brdrs\brdrw20\brsp360\brdrcf24 \pgbrdrr\brdrs\brdrw20\brsp320\brdrcf24 \sectdefaultcl\sftnbj {\rtlch\fcs1 
\ab\af1\afs18 \ltrch\fcs0 \b\f161\fs18\cf27\insrsid12133972\charrsid12255748 {\*\bkmkend P5pNijd5MpP3a5Ko2dHf} }{\rtlch\fcs1 \ab\af1\afs18 \ltrch\fcs0 \b\f161\fs18\cf27\insrsid15341153\charrsid12255748 
\par }{\rtlch\fcs1 \af1\afs18 \ltrch\fcs0 \f161\fs18\cf27\insrsid2580128\charrsid10757343 Phone:}{\rtlch\fcs1 \af0\afs18 \ltrch\fcs0 \f161\fs18\insrsid10819794\charrsid10757343  {\*\bkmkstart PTto1sY9C52T2DMdTkju}}{\field\fldedit{\*\fldinst {\rtlch\fcs1 
\af1\afs18 \ltrch\fcs0 \f161\fs18\insrsid10819794\charrsid10757343  FORMTEXT }{\rtlch\fcs1 \af1\afs18 \ltrch\fcs0 \f161\fs18\insrsid10819794\charrsid10757343 {\*\datafield 
0002000014000000145054746f317359394335325432444d64546b6a7500000000000000000000000000}{\*\formfield{\fftype0\ffprot\fftypetxt0\ffhps20{\*\ffname PTto1sY9C52T2DMdTkju}}}}}{\fldrslt {\rtlch\fcs1 \af1\afs18 \ltrch\fcs0 
\f161\fs18\insrsid10819794\charrsid10757343 Patient Home Telephone}}}\sectd \ltrsect\linex0\headery0\footery70\endnhere\pgbrdropt32\pgbrdrt\brdrs\brdrw20\brsp340\brdrcf24 \pgbrdrl\brdrs\brdrw20\brsp340\brdrcf24 \pgbrdrb\brdrs\brdrw20\brsp360\brdrcf24 
\pgbrdrr\brdrs\brdrw20\brsp320\brdrcf24 \sectdefaultcl\sftnbj {\rtlch\fcs1 \af1\afs18 \ltrch\fcs0 \f161\fs18\insrsid10819794\charrsid10757343 {\*\bkmkend PTto1sY9C52T2DMdTkju} }{\rtlch\fcs1 \af1\afs18 \ltrch\fcs0 \f161\fs18\insrsid344866\charrsid10757343 

\par }{\rtlch\fcs1 \af1\afs18 \ltrch\fcs0 \f161\fs18\cf27\insrsid2580128\charrsid10757343 Mobile:}{\rtlch\fcs1 \af1\afs18 \ltrch\fcs0 \f161\fs18\insrsid10819794\charrsid10757343  {\*\bkmkstart PV1MvgH3XlyaVidiJVr5}}{\field\fldedit{\*\fldinst {\rtlch\fcs1 
\af1\afs18 \ltrch\fcs0 \f161\fs18\insrsid10819794\charrsid10757343  FORMTEXT }{\rtlch\fcs1 \af1\afs18 \ltrch\fcs0 \f161\fs18\insrsid10819794\charrsid10757343 {\*\datafield 
0002000014000000145056314d76674833586c7961566964694a56723500000000000000000000000000}{\*\formfield{\fftype0\ffprot\fftypetxt0\ffhps20{\*\ffname PV1MvgH3XlyaVidiJVr5}}}}}{\fldrslt {\rtlch\fcs1 \af1\afs18 \ltrch\fcs0 
\f161\fs18\insrsid10819794\charrsid10757343 Patient Mobile Telephone}}}\sectd \ltrsect\linex0\headery0\footery70\endnhere\pgbrdropt32\pgbrdrt\brdrs\brdrw20\brsp340\brdrcf24 \pgbrdrl\brdrs\brdrw20\brsp340\brdrcf24 \pgbrdrb\brdrs\brdrw20\brsp360\brdrcf24 
\pgbrdrr\brdrs\brdrw20\brsp320\brdrcf24 \sectdefaultcl\sftnbj {\rtlch\fcs1 \af1\afs18 \ltrch\fcs0 \f161\fs18\insrsid10819794\charrsid10757343 {\*\bkmkend PV1MvgH3XlyaVidiJVr5} }{\rtlch\fcs1 \af1\afs18 \ltrch\fcs0 \f161\fs18\insrsid344866\charrsid10757343 

\par }\pard \ltrpar\s19\ql \li68\ri0\sb26\nowidctlpar\intbl\wrapdefault\faauto\adjustright\rin0\lin68\pararsid10819794 {\rtlch\fcs1 \af1\afs18 \ltrch\fcs0 \f161\fs18\cf27\insrsid2580128\charrsid10757343 Email:}{\rtlch\fcs1 \af1\afs18 \ltrch\fcs0 
\f161\fs18\insrsid10819794\charrsid10757343  {\*\bkmkstart PM84AYRWA6mRPje8VTJY}}{\field\fldedit{\*\fldinst {\rtlch\fcs1 \af1\afs18 \ltrch\fcs0 \f161\fs18\insrsid10819794\charrsid10757343  FORMTEXT }{\rtlch\fcs1 \af1\afs18 \ltrch\fcs0 
\f161\fs18\insrsid10819794\charrsid10757343 {\*\datafield 000200001400000014504d38344159525741366d52506a653856544a5900000000000000000000000000}{\*\formfield{\fftype0\ffprot\fftypetxt0\ffhps20{\*\ffname PM84AYRWA6mRPje8VTJY}}}}}{\fldrslt {\rtlch\fcs1 
\af1\afs18 \ltrch\fcs0 \f161\fs18\insrsid10819794\charrsid10757343 Patient E-mail Address}}}\sectd \ltrsect\linex0\headery0\footery70\endnhere\pgbrdropt32\pgbrdrt\brdrs\brdrw20\brsp340\brdrcf24 \pgbrdrl\brdrs\brdrw20\brsp340\brdrcf24 \pgbrdrb
\brdrs\brdrw20\brsp360\brdrcf24 \pgbrdrr\brdrs\brdrw20\brsp320\brdrcf24 \sectdefaultcl\sftnbj {\rtlch\fcs1 \af0\afs18 \ltrch\fcs0 \f161\fs18\insrsid10819794\charrsid10757343 {\*\bkmkend PM84AYRWA6mRPje8VTJY} }{\rtlch\fcs1 \af1\afs18 \ltrch\fcs0 
\f161\fs18\insrsid344866\charrsid10757343 \cell }\pard \ltrpar\s19\ql \li0\ri0\sb28\nowidctlpar\intbl\wrapdefault\faauto\adjustright\rin0\lin0\pararsid5460777 {\rtlch\fcs1 \af1\afs18 \ltrch\fcs0 \b\f161\fs18\cf27\insrsid2580128\charrsid10757343 
Patient Address}{\rtlch\fcs1 \af1\afs18 \ltrch\fcs0 \b\f161\fs18\insrsid344866\charrsid10757343 
\par }\pard \ltrpar\s19\ql \li0\ri0\sb77\nowidctlpar\intbl\wrapdefault\faauto\adjustright\rin0\lin0\pararsid5339365 {\*\bkmkstart PwxaU4fedGstIu5qmBSt}{\field\fldedit{\*\fldinst {\rtlch\fcs1 \af1\afs18 \ltrch\fcs0 
\f161\fs18\cf27\insrsid10819794\charrsid10757343  FORMTEXT }{\rtlch\fcs1 \af1\afs18 \ltrch\fcs0 \f161\fs18\cf27\insrsid10819794\charrsid10757343 {\*\datafield 000200001400000014507778615534666564477374497535716d42537400000000000000000000000000}
{\*\formfield{\fftype0\ffprot\fftypetxt0\ffhps20{\*\ffname PwxaU4fedGstIu5qmBSt}}}}}{\fldrslt {\rtlch\fcs1 \af1\afs18 \ltrch\fcs0 \f161\fs18\cf27\insrsid10819794\charrsid10757343 Home Full Address (stacked)}}}\sectd \ltrsect
\linex0\headery0\footery70\endnhere\pgbrdropt32\pgbrdrt\brdrs\brdrw20\brsp340\brdrcf24 \pgbrdrl\brdrs\brdrw20\brsp340\brdrcf24 \pgbrdrb\brdrs\brdrw20\brsp360\brdrcf24 \pgbrdrr\brdrs\brdrw20\brsp320\brdrcf24 \sectdefaultcl\sftnbj {\rtlch\fcs1 \af1\afs18 
\ltrch\fcs0 \f161\fs18\cf27\insrsid10819794\charrsid10757343 {\*\bkmkend PwxaU4fedGstIu5qmBSt} }{\rtlch\fcs1 \af1\afs18 \ltrch\fcs0 \f161\fs18\cf27\insrsid8851526\charrsid10757343 
\par }\pard \ltrpar\s19\ql \li0\ri0\sb27\nowidctlpar\intbl\wrapdefault\faauto\adjustright\rin0\lin0\pararsid10819794 {\rtlch\fcs1 \af1\afs18 \ltrch\fcs0 \f161\fs18\insrsid344866\charrsid10757343 \cell }\pard\plain \ltrpar
\ql \li0\ri0\nowidctlpar\intbl\wrapdefault\aspalpha\aspnum\faauto\adjustright\rin0\lin0 \rtlch\fcs1 \af1\afs22\alang1025 \ltrch\fcs0 \f1\fs22\lang1033\langfe1033\cgrid\langnp1033\langfenp1033 {\rtlch\fcs1 \af1\afs18 \ltrch\fcs0 
\f161\fs18\insrsid344866\charrsid10757343 \trowd \irow2\irowband2\ltrrow\ts11\trrh-2020\trleft142\trbrdrt\brdrs\brdrw30\brdrcf25 \trbrdrl\brdrs\brdrw30\brdrcf25 \trbrdrb\brdrs\brdrw30\brdrcf25 \trbrdrr\brdrs\brdrw30\brdrcf25 \trbrdrh
\brdrs\brdrw30\brdrcf25 \trbrdrv\brdrs\brdrw30\brdrcf25 \trftsWidth1\trftsWidthB3\trpaddfl3\trpaddft3\trpaddfb3\trpaddfr3\tblrsid5460777\tbllkhdrrows\tbllklastrow\tbllkhdrcols\tbllklastcol\tblind142\tblindtype3 \clvertalt\clbrdrt\brdrs\brdrw30\brdrcf25 
\clbrdrl\brdrs\brdrw30\brdrcf25 \clbrdrb\brdrs\brdrw10\brdrcf25 \clbrdrr\brdrs\brdrw30\brdrcf25 \cltxlrtb\clftsWidth3\clwWidth3969\clshdrawnil \cellx4111\clvertalt\clbrdrt\brdrs\brdrw30\brdrcf25 \clbrdrl\brdrs\brdrw30\brdrcf25 \clbrdrb
\brdrs\brdrw10\brdrcf25 \clbrdrr\brdrs\brdrw30\brdrcf25 \cltxlrtb\clftsWidth3\clwWidth3524\clshdrawnil \cellx7635\row \ltrrow}\trowd \irow3\irowband3\ltrrow\ts11\trrh-405\trleft142\trbrdrt\brdrs\brdrw30\brdrcf25 \trbrdrl\brdrs\brdrw30\brdrcf25 \trbrdrb
\brdrs\brdrw30\brdrcf25 \trbrdrr\brdrs\brdrw30\brdrcf25 \trbrdrh\brdrs\brdrw30\brdrcf25 \trbrdrv\brdrs\brdrw30\brdrcf25 
\trftsWidth1\trftsWidthB3\trpaddfl3\trpaddft3\trpaddfb3\trpaddfr3\tblrsid5339365\tbllkhdrrows\tbllklastrow\tbllkhdrcols\tbllklastcol\tblind142\tblindtype3 \clvertalt\clbrdrt\brdrs\brdrw10\brdrcf25 \clbrdrl\brdrs\brdrw30\brdrcf25 \clbrdrb
\brdrs\brdrw10\brdrcf25 \clbrdrr\brdrs\brdrw30\brdrcf25 \cltxlrtb\clftsWidth3\clwWidth3969\clshdrawnil \cellx4111\clvertalt\clbrdrt\brdrs\brdrw10\brdrcf25 \clbrdrl\brdrs\brdrw30\brdrcf25 \clbrdrb\brdrs\brdrw15\brdrcf28 \clbrdrr\brdrs\brdrw30\brdrcf25 
\cltxlrtb\clftsWidth3\clwWidth3524\clshdrawnil \cellx7635\pard\plain \ltrpar\s19\ql \li59\ri0\sb84\nowidctlpar\intbl\wrapdefault\faauto\adjustright\rin0\lin59\pararsid10819794 \rtlch\fcs1 \af1\afs22\alang1025 \ltrch\fcs0 
\f1\fs22\lang1033\langfe1033\cgrid\langnp1033\langfenp1033 {\rtlch\fcs1 \af1\afs18 \ltrch\fcs0 \b\f161\fs18\cf27\insrsid2580128\charrsid10757343 Patient NHS Number}{\rtlch\fcs1 \af1\afs18 \ltrch\fcs0 \b\f161\fs18\cf27\insrsid10819794\charrsid10757343  
{\*\bkmkstart PVMS3GUNOSPhtrC6fHwn}}{\field\fldedit{\*\fldinst {\rtlch\fcs1 \ab\af1\afs18 \ltrch\fcs0 \f161\fs18\cf27\insrsid10819794\charrsid12255748  FORMTEXT }{\rtlch\fcs1 \ab\af1\afs18 \ltrch\fcs0 \f161\fs18\cf27\insrsid10819794\charrsid12255748 
{\*\datafield 00020000140000001450564d533347554e4f535068747243366648776e00000000000000000000000000}{\*\formfield{\fftype0\ffprot\fftypetxt0\ffhps20{\*\ffname PVMS3GUNOSPhtrC6fHwn}}}}}{\fldrslt {\rtlch\fcs1 \ab\af1\afs18 \ltrch\fcs0 
\f161\fs18\cf27\insrsid10819794\charrsid12255748 NHS Number}}}\sectd \ltrsect\linex0\headery0\footery70\endnhere\pgbrdropt32\pgbrdrt\brdrs\brdrw20\brsp340\brdrcf24 \pgbrdrl\brdrs\brdrw20\brsp340\brdrcf24 \pgbrdrb\brdrs\brdrw20\brsp360\brdrcf24 \pgbrdrr
\brdrs\brdrw20\brsp320\brdrcf24 \sectdefaultcl\sftnbj {\rtlch\fcs1 \af1\afs18 \ltrch\fcs0 \b\f161\fs18\cf27\insrsid10819794\charrsid10757343 {\*\bkmkend PVMS3GUNOSPhtrC6fHwn} }{\rtlch\fcs1 \af1\afs18 \ltrch\fcs0 
\b\f161\fs18\insrsid344866\charrsid10757343 \cell }{\rtlch\fcs1 \af1\afs18 \ltrch\fcs0 \b\f161\fs18\cf27\insrsid2580128\charrsid10757343 Patient Date of Birth}{\rtlch\fcs1 \af1\afs18 \ltrch\fcs0 \b\f161\fs18\cf27\insrsid10819794\charrsid10757343  
{\*\bkmkstart P5vvyFDJkT4wnOxhjzlI}}{\field\fldedit{\*\fldinst {\rtlch\fcs1 \ab\af1\afs18 \ltrch\fcs0 \f161\fs18\cf27\insrsid10819794\charrsid12255748  FORMTEXT }{\rtlch\fcs1 \ab\af1\afs18 \ltrch\fcs0 \f161\fs18\cf27\insrsid10819794\charrsid12255748 
{\*\datafield 000200001400000014503576767946444a6b5434776e4f78686a7a6c4900000000000000000000000000}{\*\formfield{\fftype0\ffprot\fftypetxt0\ffhps20{\*\ffname P5vvyFDJkT4wnOxhjzlI}}}}}{\fldrslt {\rtlch\fcs1 \ab\af1\afs18 \ltrch\fcs0 
\f161\fs18\cf27\insrsid10819794\charrsid12255748 Date of Birth}}}\sectd \ltrsect\linex0\headery0\footery70\endnhere\pgbrdropt32\pgbrdrt\brdrs\brdrw20\brsp340\brdrcf24 \pgbrdrl\brdrs\brdrw20\brsp340\brdrcf24 \pgbrdrb\brdrs\brdrw20\brsp360\brdrcf24 \pgbrdrr
\brdrs\brdrw20\brsp320\brdrcf24 \sectdefaultcl\sftnbj {\rtlch\fcs1 \af1\afs18 \ltrch\fcs0 \b\f161\fs18\cf27\insrsid10819794\charrsid10757343 {\*\bkmkend P5vvyFDJkT4wnOxhjzlI} }{\rtlch\fcs1 \af1\afs18 \ltrch\fcs0 
\b\f161\fs18\insrsid344866\charrsid10757343 \cell }\pard\plain \ltrpar\ql \li0\ri0\nowidctlpar\intbl\wrapdefault\aspalpha\aspnum\faauto\adjustright\rin0\lin0 \rtlch\fcs1 \af1\afs22\alang1025 \ltrch\fcs0 
\f1\fs22\lang1033\langfe1033\cgrid\langnp1033\langfenp1033 {\rtlch\fcs1 \af1\afs18 \ltrch\fcs0 \f161\fs18\insrsid344866\charrsid10757343 \trowd \irow3\irowband3\ltrrow\ts11\trrh-405\trleft142\trbrdrt\brdrs\brdrw30\brdrcf25 \trbrdrl\brdrs\brdrw30\brdrcf25 
\trbrdrb\brdrs\brdrw30\brdrcf25 \trbrdrr\brdrs\brdrw30\brdrcf25 \trbrdrh\brdrs\brdrw30\brdrcf25 \trbrdrv\brdrs\brdrw30\brdrcf25 
\trftsWidth1\trftsWidthB3\trpaddfl3\trpaddft3\trpaddfb3\trpaddfr3\tblrsid5339365\tbllkhdrrows\tbllklastrow\tbllkhdrcols\tbllklastcol\tblind142\tblindtype3 \clvertalt\clbrdrt\brdrs\brdrw10\brdrcf25 \clbrdrl\brdrs\brdrw30\brdrcf25 \clbrdrb
\brdrs\brdrw10\brdrcf25 \clbrdrr\brdrs\brdrw30\brdrcf25 \cltxlrtb\clftsWidth3\clwWidth3969\clshdrawnil \cellx4111\clvertalt\clbrdrt\brdrs\brdrw10\brdrcf25 \clbrdrl\brdrs\brdrw30\brdrcf25 \clbrdrb\brdrs\brdrw15\brdrcf28 \clbrdrr\brdrs\brdrw30\brdrcf25 
\cltxlrtb\clftsWidth3\clwWidth3524\clshdrawnil \cellx7635\row \ltrrow}\trowd \irow4\irowband4\ltrrow\ts11\trrh-1521\trleft142\trbrdrt\brdrs\brdrw30\brdrcf25 \trbrdrl\brdrs\brdrw30\brdrcf25 \trbrdrb\brdrs\brdrw30\brdrcf25 \trbrdrr\brdrs\brdrw30\brdrcf25 
\trbrdrh\brdrs\brdrw30\brdrcf25 \trbrdrv\brdrs\brdrw30\brdrcf25 \trftsWidth1\trftsWidthB3\trpaddfl3\trpaddft3\trpaddfb3\trpaddfr3\tblrsid5339365\tbllkhdrrows\tbllklastrow\tbllkhdrcols\tbllklastcol\tblind142\tblindtype3 \clvertalt\clbrdrt
\brdrs\brdrw10\brdrcf25 \clbrdrl\brdrs\brdrw30\brdrcf25 \clbrdrb\brdrs\brdrw10\brdrcf25 \clbrdrr\brdrs\brdrw30\brdrcf25 \cltxlrtb\clftsWidth3\clwWidth3969\clshdrawnil \cellx4111\clvertalt\clbrdrt\brdrs\brdrw10\brdrcf25 \clbrdrl\brdrs\brdrw30\brdrcf25 
\clbrdrb\brdrs\brdrw15\brdrcf28 \clbrdrr\brdrs\brdrw30\brdrcf25 \cltxlrtb\clftsWidth3\clwWidth3524\clshdrawnil \cellx7635\pard\plain \ltrpar\s19\ql \li59\ri0\sb84\nowidctlpar\intbl\wrapdefault\faauto\adjustright\rin0\lin59\pararsid15679563 \rtlch\fcs1 
\af1\afs22\alang1025 \ltrch\fcs0 \f1\fs22\lang1033\langfe1033\cgrid\langnp1033\langfenp1033 {\rtlch\fcs1 \af1\afs18 \ltrch\fcs0 \b\f161\fs18\cf27\insrsid159964\charrsid10757343 Notes:}{\field\flddirty{\*\fldinst {\rtlch\fcs1 \af1\afs18 \ltrch\fcs0 
\b\f161\fs18\cf27\insrsid159964\charrsid10757343 {\*\bkmkstart Text5} FORMTEXT }{\rtlch\fcs1 \af1\afs18 \ltrch\fcs0 \b\f161\fs18\cf27\insrsid159964\charrsid10757343 {\*\datafield 000000001400000005546578743500000000000000000000000000}
{\*\formfield{\fftype0\fftypetxt0\ffhps20{\*\ffname Text5}}}}}{\fldrslt {\rtlch\fcs1 \af1\afs18 \ltrch\fcs0 \b\f161\fs18\cf27\lang1024\langfe1024\noproof\insrsid159964\charrsid10757343 \u8194\'20\u8194\'20\u8194\'20\u8194\'20\u8194\'20}}}\sectd \ltrsect
\linex0\headery0\footery70\endnhere\pgbrdropt32\pgbrdrt\brdrs\brdrw20\brsp340\brdrcf24 \pgbrdrl\brdrs\brdrw20\brsp340\brdrcf24 \pgbrdrb\brdrs\brdrw20\brsp360\brdrcf24 \pgbrdrr\brdrs\brdrw20\brsp320\brdrcf24 \sectdefaultcl\sftnbj {\rtlch\fcs1 \af1\afs18 
\ltrch\fcs0 \b\f161\fs18\cf27\insrsid159964\charrsid10757343 {\*\bkmkend Text5}
\par }\pard \ltrpar\s19\ql \li59\ri0\sb84\nowidctlpar\intbl\wrapdefault\faauto\adjustright\rin0\lin59\pararsid1982668 {\field\fldedit{\*\fldinst {\rtlch\fcs1 \ab\af1\afs18 \ltrch\fcs0 \f161\fs18\cf27\insrsid7690757 {\*\bkmkstart TnkjofW1vo9OAZ7Xdl1Y} FORMTEXT 
}{\rtlch\fcs1 \ab\af1\afs18 \ltrch\fcs0 \f161\fs18\cf27\insrsid7690757 {\*\datafield 000200001400000014546e6b6a6f665731766f394f415a3758646c315900000000000000000000000000}{\*\formfield{\fftype0\ffprot\fftypetxt0\ffhps20{\*\ffname TnkjofW1vo9OAZ7Xdl1Y}}}}
}{\fldrslt {\rtlch\fcs1 \ab\af1\afs18 \ltrch\fcs0 \f161\fs18\cf27\insrsid7690757 Single Code Entry: Standing height}}}\sectd \ltrsect\linex0\headery0\footery70\endnhere\pgbrdropt32\pgbrdrt\brdrs\brdrw20\brsp340\brdrcf24 \pgbrdrl
\brdrs\brdrw20\brsp340\brdrcf24 \pgbrdrb\brdrs\brdrw20\brsp360\brdrcf24 \pgbrdrr\brdrs\brdrw20\brsp320\brdrcf24 \sectdefaultcl\sftnbj {\rtlch\fcs1 \ab\af1\afs18 \ltrch\fcs0 \f161\fs18\cf27\insrsid7690757 {\*\bkmkend TnkjofW1vo9OAZ7Xdl1Y}  
\par }{\field\fldedit{\*\fldinst {\rtlch\fcs1 \ab\af1\afs18 \ltrch\fcs0 \f161\fs18\cf27\insrsid5517747 {\*\bkmkstart TOtzKIeU4V63j5tPqKQp} FORMTEXT }{\rtlch\fcs1 \ab\af1\afs18 \ltrch\fcs0 \f161\fs18\cf27\insrsid5517747 {\*\datafield 
000200001400000014544f747a4b496555345636336a357450714b517000000000000000000000000000}{\*\formfield{\fftype0\ffprot\fftypetxt0\ffhps20{\*\ffname TOtzKIeU4V63j5tPqKQp}}}}}{\fldrslt {\rtlch\fcs1 \ab\af1\afs18 \ltrch\fcs0 \f161\fs18\cf27\insrsid5517747 
Single Code Entry: Body weight}}}\sectd \ltrsect\linex0\headery0\footery70\endnhere\pgbrdropt32\pgbrdrt\brdrs\brdrw20\brsp340\brdrcf24 \pgbrdrl\brdrs\brdrw20\brsp340\brdrcf24 \pgbrdrb\brdrs\brdrw20\brsp360\brdrcf24 \pgbrdrr\brdrs\brdrw20\brsp320\brdrcf24 
\sectdefaultcl\sftnbj {\rtlch\fcs1 \ab\af1\afs18 \ltrch\fcs0 \f161\fs18\cf27\insrsid5517747 {\*\bkmkend TOtzKIeU4V63j5tPqKQp}
\par }{\field\fldedit{\*\fldinst {\rtlch\fcs1 \ab\af1\afs18 \ltrch\fcs0 \f161\fs18\cf27\insrsid5517747 {\*\bkmkstart Tk2BlrjZ4Ycq58HVOVKu} FORMTEXT }{\rtlch\fcs1 \ab\af1\afs18 \ltrch\fcs0 \f161\fs18\cf27\insrsid5517747 {\*\datafield 
000200001400000014546b32426c726a5a34596371353848564f564b7500000000000000000000000000}{\*\formfield{\fftype0\ffprot\fftypetxt0\ffhps20{\*\ffname Tk2BlrjZ4Ycq58HVOVKu}}}}}{\fldrslt {\rtlch\fcs1 \ab\af1\afs18 \ltrch\fcs0 \f161\fs18\cf27\insrsid5517747 
Single Code Entry: Body mass index}}}\sectd \ltrsect\linex0\headery0\footery70\endnhere\pgbrdropt32\pgbrdrt\brdrs\brdrw20\brsp340\brdrcf24 \pgbrdrl\brdrs\brdrw20\brsp340\brdrcf24 \pgbrdrb\brdrs\brdrw20\brsp360\brdrcf24 \pgbrdrr
\brdrs\brdrw20\brsp320\brdrcf24 \sectdefaultcl\sftnbj {\rtlch\fcs1 \ab\af1\afs18 \ltrch\fcs0 \f161\fs18\cf27\insrsid5517747 {\*\bkmkend Tk2BlrjZ4Ycq58HVOVKu}    }{\rtlch\fcs1 \ab\af1\afs18 \ltrch\fcs0 \f161\fs18\cf27\insrsid159964\charrsid10757343 
\par }\pard \ltrpar\s19\ql \li59\ri0\sb84\nowidctlpar\intbl\wrapdefault\faauto\adjustright\rin0\lin59\pararsid10819794 {\rtlch\fcs1 \af1\afs18 \ltrch\fcs0 \b\f161\fs18\cf27\insrsid159964\charrsid10757343 
\par }\pard \ltrpar\s19\ql \li0\ri0\sb84\nowidctlpar\intbl\wrapdefault\faauto\adjustright\rin0\lin0\pararsid159964 {\rtlch\fcs1 \af1\afs18 \ltrch\fcs0 \b\f161\fs18\cf27\insrsid159964\charrsid10757343 \cell }\pard \ltrpar
\s19\ql \li59\ri0\sb84\nowidctlpar\intbl\wrapdefault\faauto\adjustright\rin0\lin59\pararsid5517747 {\field\fldedit{\*\fldinst {\rtlch\fcs1 \af1\afs18 \ltrch\fcs0 \b\f161\fs18\cf27\insrsid12255748 {\*\bkmkstart Tih3EuRtkUuEapLorXhF} FORMTEXT }{\rtlch\fcs1 
\af1\afs18 \ltrch\fcs0 \b\f161\fs18\cf27\insrsid12255748 {\*\datafield 00020000140000001454696833457552746b55754561704c6f7258684600000000000000000000000000}{\*\formfield{\fftype0\ffprot\fftypetxt0\ffhps20{\*\ffname Tih3EuRtkUuEapLorXhF}}}}}{\fldrslt {
\rtlch\fcs1 \af1\afs18 \ltrch\fcs0 \b\f161\fs18\cf27\insrsid12255748 Single Code Entry: Never smoked tobacco...}}}\sectd \ltrsect\linex0\headery0\footery70\endnhere\pgbrdropt32\pgbrdrt\brdrs\brdrw20\brsp340\brdrcf24 \pgbrdrl
\brdrs\brdrw20\brsp340\brdrcf24 \pgbrdrb\brdrs\brdrw20\brsp360\brdrcf24 \pgbrdrr\brdrs\brdrw20\brsp320\brdrcf24 \sectdefaultcl\sftnbj {\rtlch\fcs1 \af1\afs18 \ltrch\fcs0 \b\f161\fs18\cf27\insrsid12255748 {\*\bkmkend Tih3EuRtkUuEapLorXhF}  }{\rtlch\fcs1 
\af1\afs18 \ltrch\fcs0 \b\f161\fs18\cf27\insrsid159964\charrsid10757343 \cell }\pard\plain \ltrpar\ql \li0\ri0\nowidctlpar\intbl\wrapdefault\aspalpha\aspnum\faauto\adjustright\rin0\lin0 \rtlch\fcs1 \af1\afs22\alang1025 \ltrch\fcs0 
\f1\fs22\lang1033\langfe1033\cgrid\langnp1033\langfenp1033 {\rtlch\fcs1 \af1\afs18 \ltrch\fcs0 \f161\fs18\insrsid159964\charrsid10757343 \trowd \irow4\irowband4\ltrrow\ts11\trrh-1521\trleft142\trbrdrt\brdrs\brdrw30\brdrcf25 \trbrdrl
\brdrs\brdrw30\brdrcf25 \trbrdrb\brdrs\brdrw30\brdrcf25 \trbrdrr\brdrs\brdrw30\brdrcf25 \trbrdrh\brdrs\brdrw30\brdrcf25 \trbrdrv\brdrs\brdrw30\brdrcf25 
\trftsWidth1\trftsWidthB3\trpaddfl3\trpaddft3\trpaddfb3\trpaddfr3\tblrsid5339365\tbllkhdrrows\tbllklastrow\tbllkhdrcols\tbllklastcol\tblind142\tblindtype3 \clvertalt\clbrdrt\brdrs\brdrw10\brdrcf25 \clbrdrl\brdrs\brdrw30\brdrcf25 \clbrdrb
\brdrs\brdrw10\brdrcf25 \clbrdrr\brdrs\brdrw30\brdrcf25 \cltxlrtb\clftsWidth3\clwWidth3969\clshdrawnil \cellx4111\clvertalt\clbrdrt\brdrs\brdrw10\brdrcf25 \clbrdrl\brdrs\brdrw30\brdrcf25 \clbrdrb\brdrs\brdrw15\brdrcf28 \clbrdrr\brdrs\brdrw30\brdrcf25 
\cltxlrtb\clftsWidth3\clwWidth3524\clshdrawnil \cellx7635\row \ltrrow}\trowd \irow5\irowband5\ltrrow\ts11\trrh-174\trleft142\trbrdrt\brdrs\brdrw30\brdrcf25 \trbrdrl\brdrs\brdrw30\brdrcf25 \trbrdrb\brdrs\brdrw30\brdrcf25 \trbrdrr\brdrs\brdrw30\brdrcf25 
\trbrdrh\brdrs\brdrw30\brdrcf25 \trbrdrv\brdrs\brdrw30\brdrcf25 \trftsWidth1\trftsWidthB3\trpaddfl3\trpaddft3\trpaddfb3\trpaddfr3\tblrsid10757343\tbllkhdrrows\tbllklastrow\tbllkhdrcols\tbllklastcol\tblind142\tblindtype3 \clvertalt\clbrdrt\brdrnone 
\clbrdrl\brdrnone \clbrdrb\brdrnone \clbrdrr\brdrnone \clcbpat25\cltxlrtb\clftsWidth3\clwWidth7493\clcbpatraw25 \cellx7635\pard\plain \ltrpar\s19\ql \li74\ri0\sl-170\slmult0\nowidctlpar\intbl\wrapdefault\faauto\adjustright\rin0\lin74 \rtlch\fcs1 
\af1\afs22\alang1025 \ltrch\fcs0 \f1\fs22\lang1033\langfe1033\cgrid\langnp1033\langfenp1033 {\rtlch\fcs1 \af1\afs18 \ltrch\fcs0 \b\f161\fs18\cf8\insrsid2580128\charrsid10757343 GP Confirmation}{\rtlch\fcs1 \af1\afs18 \ltrch\fcs0 
\b\f161\fs18\insrsid344866\charrsid10757343 \cell }\pard\plain \ltrpar\ql \li0\ri0\nowidctlpar\intbl\wrapdefault\aspalpha\aspnum\faauto\adjustright\rin0\lin0 \rtlch\fcs1 \af1\afs22\alang1025 \ltrch\fcs0 
\f1\fs22\lang1033\langfe1033\cgrid\langnp1033\langfenp1033 {\rtlch\fcs1 \af1\afs18 \ltrch\fcs0 \f161\fs18\insrsid344866\charrsid10757343 \trowd \irow5\irowband5\ltrrow\ts11\trrh-174\trleft142\trbrdrt\brdrs\brdrw30\brdrcf25 \trbrdrl\brdrs\brdrw30\brdrcf25 
\trbrdrb\brdrs\brdrw30\brdrcf25 \trbrdrr\brdrs\brdrw30\brdrcf25 \trbrdrh\brdrs\brdrw30\brdrcf25 \trbrdrv\brdrs\brdrw30\brdrcf25 
\trftsWidth1\trftsWidthB3\trpaddfl3\trpaddft3\trpaddfb3\trpaddfr3\tblrsid10757343\tbllkhdrrows\tbllklastrow\tbllkhdrcols\tbllklastcol\tblind142\tblindtype3 \clvertalt\clbrdrt\brdrnone \clbrdrl\brdrnone \clbrdrb\brdrnone \clbrdrr\brdrnone 
\clcbpat25\cltxlrtb\clftsWidth3\clwWidth7493\clcbpatraw25 \cellx7635\row \ltrrow}\trowd \irow6\irowband6\ltrrow\ts11\trrh-481\trleft142\trbrdrt\brdrs\brdrw30\brdrcf25 \trbrdrl\brdrs\brdrw30\brdrcf25 \trbrdrb\brdrs\brdrw30\brdrcf25 \trbrdrr
\brdrs\brdrw30\brdrcf25 \trbrdrh\brdrs\brdrw30\brdrcf25 \trbrdrv\brdrs\brdrw30\brdrcf25 \trftsWidth1\trftsWidthB3\trpaddfl3\trpaddft3\trpaddfb3\trpaddfr3\tblrsid5339365\tbllkhdrrows\tbllklastrow\tbllkhdrcols\tbllklastcol\tblind142\tblindtype3 \clvertalt
\clbrdrt\brdrnone \clbrdrl\brdrs\brdrw30\brdrcf25 \clbrdrb\brdrs\brdrw10\brdrcf25 \clbrdrr\brdrs\brdrw30\brdrcf25 \cltxlrtb\clftsWidth3\clwWidth3969\clshdrawnil \cellx4111\clvmgf\clvertalt\clbrdrt\brdrnone \clbrdrl\brdrs\brdrw30\brdrcf25 \clbrdrb
\brdrs\brdrw30\brdrcf25 \clbrdrr\brdrs\brdrw30\brdrcf25 \cltxlrtb\clftsWidth3\clwWidth3524\clshdrawnil \cellx7635\pard\plain \ltrpar\s19\ql \li59\ri0\sb118\nowidctlpar\intbl\wrapdefault\faauto\adjustright\rin0\lin59\pararsid10819794 \rtlch\fcs1 
\af1\afs22\alang1025 \ltrch\fcs0 \f1\fs22\lang1033\langfe1033\cgrid\langnp1033\langfenp1033 {\rtlch\fcs1 \af1\afs18 \ltrch\fcs0 \b\f161\fs18\cf27\insrsid2580128\charrsid10757343 GP }{\rtlch\fcs1 \af1\afs18 \ltrch\fcs0 
\b\f161\fs18\cf27\insrsid9727380\charrsid10757343 : }{\field\fldedit{\*\fldinst {\rtlch\fcs1 \af1\afs18 \ltrch\fcs0 \b\f161\fs18\cf27\insrsid9727380\charrsid10757343 {\*\bkmkstart u7Qp9bgkJsWEMAnnUXqg} FORMTEXT }{\rtlch\fcs1 \af1\afs18 \ltrch\fcs0 
\b\f161\fs18\cf27\insrsid9727380\charrsid10757343 {\*\datafield 000200001400000014753751703962676b4a7357454d416e6e5558716700000000000000000000000000}{\*\formfield{\fftype0\ffprot\fftypetxt0\ffhps20{\*\ffname u7Qp9bgkJsWEMAnnUXqg}}}}}{\fldrslt {
\rtlch\fcs1 \af1\afs18 \ltrch\fcs0 \b\f161\fs18\cf27\insrsid9727380\charrsid10757343 Current User}}}\sectd \ltrsect\linex0\headery0\footery70\endnhere\pgbrdropt32\pgbrdrt\brdrs\brdrw20\brsp340\brdrcf24 \pgbrdrl\brdrs\brdrw20\brsp340\brdrcf24 \pgbrdrb
\brdrs\brdrw20\brsp360\brdrcf24 \pgbrdrr\brdrs\brdrw20\brsp320\brdrcf24 \sectdefaultcl\sftnbj {\rtlch\fcs1 \af1\afs18 \ltrch\fcs0 \b\f161\fs18\cf27\insrsid9727380\charrsid10757343 {\*\bkmkend u7Qp9bgkJsWEMAnnUXqg} }{\rtlch\fcs1 \af1\afs18 \ltrch\fcs0 
\b\f161\fs18\insrsid344866\charrsid10757343 \cell }\pard\plain \ltrpar\ql \li0\ri0\nowidctlpar\intbl\wrapdefault\faauto\adjustright\rin0\lin0\pararsid2251537 \rtlch\fcs1 \af1\afs22\alang1025 \ltrch\fcs0 
\f1\fs22\lang1033\langfe1033\cgrid\langnp1033\langfenp1033 {\rtlch\fcs1 \af1\afs18 \ltrch\fcs0 \b\f161\fs18\cf27\insrsid2251537\charrsid10757343 Date }{\field\fldedit{\*\fldinst {\rtlch\fcs1 \af1\afs18 \ltrch\fcs0 
\b\f161\fs18\cf27\insrsid2251537\charrsid10757343 {\*\bkmkstart dA8rkCWvT22nklCq6lNo} FORMTEXT }{\rtlch\fcs1 \af1\afs18 \ltrch\fcs0 \b\f161\fs18\cf27\insrsid2251537\charrsid10757343 {\*\datafield 
000200001400000014644138726b4357765432326e6b6c4371366c4e6f00000000000000000000000000}{\*\formfield{\fftype0\ffprot\fftypetxt0\ffhps20{\*\ffname dA8rkCWvT22nklCq6lNo}}}}}{\fldrslt {\rtlch\fcs1 \af1\afs18 \ltrch\fcs0 
\b\f161\fs18\cf27\insrsid2251537\charrsid10757343 Short date letter merged}}}\sectd \ltrsect\linex0\headery0\footery70\endnhere\pgbrdropt32\pgbrdrt\brdrs\brdrw20\brsp340\brdrcf24 \pgbrdrl\brdrs\brdrw20\brsp340\brdrcf24 \pgbrdrb
\brdrs\brdrw20\brsp360\brdrcf24 \pgbrdrr\brdrs\brdrw20\brsp320\brdrcf24 \sectdefaultcl\sftnbj {\rtlch\fcs1 \af1\afs18 \ltrch\fcs0 \f161\fs18\insrsid344866\charrsid10757343 {\*\bkmkend dA8rkCWvT22nklCq6lNo}\cell }\pard \ltrpar
\ql \li0\ri0\nowidctlpar\intbl\wrapdefault\aspalpha\aspnum\faauto\adjustright\rin0\lin0 {\rtlch\fcs1 \af1\afs18 \ltrch\fcs0 \f161\fs18\insrsid344866\charrsid10757343 \trowd \irow6\irowband6\ltrrow\ts11\trrh-481\trleft142\trbrdrt\brdrs\brdrw30\brdrcf25 
\trbrdrl\brdrs\brdrw30\brdrcf25 \trbrdrb\brdrs\brdrw30\brdrcf25 \trbrdrr\brdrs\brdrw30\brdrcf25 \trbrdrh\brdrs\brdrw30\brdrcf25 \trbrdrv\brdrs\brdrw30\brdrcf25 
\trftsWidth1\trftsWidthB3\trpaddfl3\trpaddft3\trpaddfb3\trpaddfr3\tblrsid5339365\tbllkhdrrows\tbllklastrow\tbllkhdrcols\tbllklastcol\tblind142\tblindtype3 \clvertalt\clbrdrt\brdrnone \clbrdrl\brdrs\brdrw30\brdrcf25 \clbrdrb\brdrs\brdrw10\brdrcf25 \clbrdrr
\brdrs\brdrw30\brdrcf25 \cltxlrtb\clftsWidth3\clwWidth3969\clshdrawnil \cellx4111\clvmgf\clvertalt\clbrdrt\brdrnone \clbrdrl\brdrs\brdrw30\brdrcf25 \clbrdrb\brdrs\brdrw30\brdrcf25 \clbrdrr\brdrs\brdrw30\brdrcf25 
\cltxlrtb\clftsWidth3\clwWidth3524\clshdrawnil \cellx7635\row \ltrrow}\trowd \irow7\irowband7\lastrow \ltrrow\ts11\trrh-490\trleft142\trbrdrt\brdrs\brdrw30\brdrcf25 \trbrdrl\brdrs\brdrw30\brdrcf25 \trbrdrb\brdrs\brdrw30\brdrcf25 \trbrdrr
\brdrs\brdrw30\brdrcf25 \trbrdrh\brdrs\brdrw30\brdrcf25 \trbrdrv\brdrs\brdrw30\brdrcf25 \trftsWidth1\trftsWidthB3\trpaddfl3\trpaddft3\trpaddfb3\trpaddfr3\tblrsid5339365\tbllkhdrrows\tbllklastrow\tbllkhdrcols\tbllklastcol\tblind142\tblindtype3 \clvertalt
\clbrdrt\brdrs\brdrw10\brdrcf25 \clbrdrl\brdrs\brdrw30\brdrcf25 \clbrdrb\brdrs\brdrw10\brdrcf25 \clbrdrr\brdrs\brdrw30\brdrcf25 \cltxlrtb\clftsWidth3\clwWidth3969\clshdrawnil \cellx4111\clvmrg\clvertalt\clbrdrt\brdrs\brdrw30\brdrcf25 \clbrdrl
\brdrs\brdrw30\brdrcf25 \clbrdrb\brdrs\brdrw30\brdrcf25 \clbrdrr\brdrs\brdrw30\brdrcf25 \cltxlrtb\clftsWidth3\clwWidth3524\clshdrawnil \cellx7635\pard\plain \ltrpar\s19\ql \li59\ri0\sb107\nowidctlpar\intbl\wrapdefault\faauto\adjustright\rin0\lin59 
\rtlch\fcs1 \af1\afs22\alang1025 \ltrch\fcs0 \f1\fs22\lang1033\langfe1033\cgrid\langnp1033\langfenp1033 {\rtlch\fcs1 \af1\afs18 \ltrch\fcs0 \b\f161\fs18\insrsid6503032 GMC: }{\field\fldedit{\*\fldinst {\rtlch\fcs1 \af1\afs18 \ltrch\fcs0 
\b\f161\fs18\insrsid6503032 {\*\bkmkstart FD1I9orEbS3C1OvRIVYs} FORMTEXT }{\rtlch\fcs1 \af1\afs18 \ltrch\fcs0 \b\f161\fs18\insrsid6503032 {\*\datafield 00020000140000001446443149396f724562533343314f76524956597300000000000000000000000000}
{\*\formfield{\fftype0\ffprot\fftypetxt0\ffhps20{\*\ffname FD1I9orEbS3C1OvRIVYs}}}}}{\fldrslt {\rtlch\fcs1 \af1\afs18 \ltrch\fcs0 \b\f161\fs18\insrsid6503032 Free Text Prompt}}}\sectd \ltrsect\linex0\headery0\footery70\endnhere\pgbrdropt32\pgbrdrt
\brdrs\brdrw20\brsp340\brdrcf24 \pgbrdrl\brdrs\brdrw20\brsp340\brdrcf24 \pgbrdrb\brdrs\brdrw20\brsp360\brdrcf24 \pgbrdrr\brdrs\brdrw20\brsp320\brdrcf24 \sectdefaultcl\sftnbj {\rtlch\fcs1 \af1\afs18 \ltrch\fcs0 \b\f161\fs18\insrsid6503032 
{\*\bkmkend FD1I9orEbS3C1OvRIVYs} }{\rtlch\fcs1 \af1\afs18 \ltrch\fcs0 \b\f161\fs18\insrsid344866\charrsid10757343 \cell }\pard\plain \ltrpar\ql \li0\ri0\nowidctlpar\intbl\wrapdefault\faauto\adjustright\rin0\lin0 \rtlch\fcs1 \af1\afs22\alang1025 
\ltrch\fcs0 \f1\fs22\lang1033\langfe1033\cgrid\langnp1033\langfenp1033 {\rtlch\fcs1 \af1\afs18 \ltrch\fcs0 \f161\fs18\insrsid344866\charrsid10757343 \cell }\pard \ltrpar
\ql \li0\ri0\nowidctlpar\intbl\wrapdefault\aspalpha\aspnum\faauto\adjustright\rin0\lin0 {\rtlch\fcs1 \af1\afs18 \ltrch\fcs0 \f161\fs18\insrsid344866\charrsid10757343 \trowd \irow7\irowband7\lastrow \ltrrow\ts11\trrh-490\trleft142\trbrdrt
\brdrs\brdrw30\brdrcf25 \trbrdrl\brdrs\brdrw30\brdrcf25 \trbrdrb\brdrs\brdrw30\brdrcf25 \trbrdrr\brdrs\brdrw30\brdrcf25 \trbrdrh\brdrs\brdrw30\brdrcf25 \trbrdrv\brdrs\brdrw30\brdrcf25 
\trftsWidth1\trftsWidthB3\trpaddfl3\trpaddft3\trpaddfb3\trpaddfr3\tblrsid5339365\tbllkhdrrows\tbllklastrow\tbllkhdrcols\tbllklastcol\tblind142\tblindtype3 \clvertalt\clbrdrt\brdrs\brdrw10\brdrcf25 \clbrdrl\brdrs\brdrw30\brdrcf25 \clbrdrb
\brdrs\brdrw10\brdrcf25 \clbrdrr\brdrs\brdrw30\brdrcf25 \cltxlrtb\clftsWidth3\clwWidth3969\clshdrawnil \cellx4111\clvmrg\clvertalt\clbrdrt\brdrs\brdrw30\brdrcf25 \clbrdrl\brdrs\brdrw30\brdrcf25 \clbrdrb\brdrs\brdrw30\brdrcf25 \clbrdrr
\brdrs\brdrw30\brdrcf25 \cltxlrtb\clftsWidth3\clwWidth3524\clshdrawnil \cellx7635\row }\pard \ltrpar\ql \li0\ri0\nowidctlpar\wrapdefault\faauto\adjustright\rin0\lin0\itap0 {\rtlch\fcs1 \af1\afs18 \ltrch\fcs0 \f161\fs18\insrsid344866\charrsid10757343 

\par \ltrrow}\trowd \irow0\irowband0\ltrrow\ts11\trrh-515\trleft101\trbrdrt\brdrs\brdrw20\brdrcf24 \trbrdrl\brdrs\brdrw20\brdrcf24 \trbrdrb\brdrs\brdrw20\brdrcf24 \trbrdrr\brdrs\brdrw20\brdrcf24 \trbrdrh\brdrs\brdrw20\brdrcf24 \trbrdrv\brdrs\brdrw20\brdrcf24 
\trftsWidth1\trftsWidthB3\trpaddfl3\trpaddft3\trpaddfb3\trpaddfr3\tbllkhdrrows\tbllklastrow\tbllkhdrcols\tbllklastcol\tblind101\tblindtype3 \clvertalt\clbrdrt\brdrnone \clbrdrl\brdrnone \clbrdrb\brdrnone \clbrdrr\brdrnone 
\clcbpat24\cltxlrtb\clftsWidth3\clwWidth7296\clcbpatraw24 \cellx7397\pard\plain \ltrpar\s19\ql \li1796\ri0\sb109\nowidctlpar\intbl\wrapdefault\faauto\adjustright\rin0\lin1796 \rtlch\fcs1 \af1\afs22\alang1025 \ltrch\fcs0 
\f1\fs22\lang1033\langfe1033\cgrid\langnp1033\langfenp1033 {\rtlch\fcs1 \af1 \ltrch\fcs0 \b\fs24\cf8\charscalex105\insrsid2580128 How to arrange an appointment}{\rtlch\fcs1 \af1 \ltrch\fcs0 \b\fs24\insrsid344866 \cell }\pard\plain \ltrpar
\ql \li0\ri0\nowidctlpar\intbl\wrapdefault\aspalpha\aspnum\faauto\adjustright\rin0\lin0 \rtlch\fcs1 \af1\afs22\alang1025 \ltrch\fcs0 \f1\fs22\lang1033\langfe1033\cgrid\langnp1033\langfenp1033 {\rtlch\fcs1 \af1 \ltrch\fcs0 \insrsid344866 
\trowd \irow0\irowband0\ltrrow\ts11\trrh-515\trleft101\trbrdrt\brdrs\brdrw20\brdrcf24 \trbrdrl\brdrs\brdrw20\brdrcf24 \trbrdrb\brdrs\brdrw20\brdrcf24 \trbrdrr\brdrs\brdrw20\brdrcf24 \trbrdrh\brdrs\brdrw20\brdrcf24 \trbrdrv\brdrs\brdrw20\brdrcf24 
\trftsWidth1\trftsWidthB3\trpaddfl3\trpaddft3\trpaddfb3\trpaddfr3\tbllkhdrrows\tbllklastrow\tbllkhdrcols\tbllklastcol\tblind101\tblindtype3 \clvertalt\clbrdrt\brdrnone \clbrdrl\brdrnone \clbrdrb\brdrnone \clbrdrr\brdrnone 
\clcbpat24\cltxlrtb\clftsWidth3\clwWidth7296\clcbpatraw24 \cellx7397\row \ltrrow}\trowd \irow1\irowband1\ltrrow\ts11\trrh-5412\trleft101\trbrdrt\brdrs\brdrw20\brdrcf24 \trbrdrl\brdrs\brdrw20\brdrcf24 \trbrdrb\brdrs\brdrw20\brdrcf24 \trbrdrr
\brdrs\brdrw20\brdrcf24 \trbrdrh\brdrs\brdrw20\brdrcf24 \trbrdrv\brdrs\brdrw20\brdrcf24 \trftsWidth1\trftsWidthB3\trpaddfl3\trpaddft3\trpaddfb3\trpaddfr3\tbllkhdrrows\tbllklastrow\tbllkhdrcols\tbllklastcol\tblind101\tblindtype3 \clvertalt\clbrdrt
\brdrs\brdrw20\brdrcf24 \clbrdrl\brdrs\brdrw20\brdrcf24 \clbrdrb\brdrs\brdrw20\brdrcf24 \clbrdrr\brdrs\brdrw10\brdrcf24 \cltxlrtb\clftsWidth3\clwWidth3648\clshdrawnil \cellx3749\clvertalt\clbrdrt\brdrs\brdrw20\brdrcf24 \clbrdrl\brdrs\brdrw10\brdrcf24 
\clbrdrb\brdrs\brdrw20\brdrcf24 \clbrdrr\brdrs\brdrw20\brdrcf24 \cltxlrtb\clftsWidth3\clwWidth3648\clshdrawnil \cellx7397\pard\plain \ltrpar\s19\ql \li64\ri0\sb104\nowidctlpar\intbl\wrapdefault\faauto\adjustright\rin0\lin64 \rtlch\fcs1 
\af1\afs22\alang1025 \ltrch\fcs0 \f1\fs22\lang1033\langfe1033\cgrid\langnp1033\langfenp1033 {\rtlch\fcs1 \af1 \ltrch\fcs0 \b\fs15\cf27\insrsid2580128 GP}{\rtlch\fcs1 \af1 \ltrch\fcs0 \b\fs15\insrsid344866 
\par }\pard \ltrpar\s19\ql \li0\ri0\sb3\nowidctlpar\intbl\wrapdefault\faauto\adjustright\rin0\lin0 {\rtlch\fcs1 \af1 \ltrch\fcs0 \b\fs15\insrsid344866 
\par {\listtext\pard\plain\ltrpar \s19 \intbl\rtlch\fcs1 \ab\af0\afs22 \ltrch\fcs0 \b\f1\fs15\cf27\lang1033\langfe1033\langnp1033\insrsid2580128 \hich\af1\dbch\af0\loch\f1 1.\tab}}\pard \ltrpar\s19\ql \fi-247\li557\ri192\nowidctlpar\intbl
\tx558\wrapdefault\faauto\ls2\adjustright\rin192\lin557 {\rtlch\fcs1 \af1 \ltrch\fcs0 \fs15\cf27\insrsid2580128 Please complete this form and clearly state who is funding the procedure. }{\rtlch\fcs1 \af1 \ltrch\fcs0 \b\fs15\cf27\insrsid2580128 
Incomplete forms will result in delays}{\rtlch\fcs1 \af1 \ltrch\fcs0 \b\fs15\cf27\insrsid344866 
\par }\pard \ltrpar\s19\ql \li0\ri0\sb3\nowidctlpar\intbl\wrapdefault\faauto\adjustright\rin0\lin0 {\rtlch\fcs1 \af1 \ltrch\fcs0 \b\fs15\insrsid344866 
\par {\listtext\pard\plain\ltrpar \s19 \intbl\rtlch\fcs1 \ab\af0\afs22 \ltrch\fcs0 \b\f1\fs15\cf27\lang1033\langfe1033\langnp1033\insrsid2580128 \hich\af1\dbch\af0\loch\f1 2.\tab}}\pard \ltrpar\s19\ql \fi-247\li557\ri0\nowidctlpar\intbl
\tx558\wrapdefault\faauto\ls2\adjustright\rin0\lin557 {\rtlch\fcs1 \af1 \ltrch\fcs0 \fs15\cf27\insrsid2580128 There are 2 ways to return this}{\rtlch\fcs1 \af1 \ltrch\fcs0 \fs15\expnd2\expndtw14\cf27\insrsid2580128  }{\rtlch\fcs1 \af1 \ltrch\fcs0 
\fs15\cf27\insrsid2580128 form:}{\rtlch\fcs1 \af1 \ltrch\fcs0 \fs15\cf27\insrsid344866 
\par }\pard \ltrpar\s19\ql \li0\ri0\sb1\nowidctlpar\intbl\wrapdefault\faauto\adjustright\rin0\lin0 {\rtlch\fcs1 \af1 \ltrch\fcs0 \b\fs15\insrsid344866 
\par }\pard \ltrpar\s19\ql \li557\ri0\nowidctlpar\intbl\wrapdefault\faauto\adjustright\rin0\lin557 {\rtlch\fcs1 \af1 \ltrch\fcs0 \b\fs15\cf27\insrsid2580128 POST}{\rtlch\fcs1 \af1 \ltrch\fcs0 \b\fs15\insrsid344866 
\par }\pard \ltrpar\s19\ql \li557\ri880\sl252\slmult1\nowidctlpar\intbl\wrapdefault\faauto\adjustright\rin880\lin557 {\rtlch\fcs1 \af1 \ltrch\fcs0 \fs15\cf27\insrsid2580128 M}{\rtlch\fcs1 \af1 \ltrch\fcs0 \fs15\cf27\insrsid8027581 SI Reproductive Choices}{
\rtlch\fcs1 \af1 \ltrch\fcs0 \fs15\cf27\insrsid2580128  UK Client Services }{\rtlch\fcs1 \af1 \ltrch\fcs0 \fs15\cf27\insrsid8027581 
\par }{\rtlch\fcs1 \af1 \ltrch\fcs0 \fs15\cf27\insrsid2580128 Zeta House}{\rtlch\fcs1 \af1 \ltrch\fcs0 \fs15\insrsid344866 
\par }\pard \ltrpar\s19\ql \li557\ri0\sl-157\slmult0\nowidctlpar\intbl\wrapdefault\faauto\adjustright\rin0\lin557 {\rtlch\fcs1 \af1 \ltrch\fcs0 \fs15\cf27\insrsid2580128 Axis 4/5}{\rtlch\fcs1 \af1 \ltrch\fcs0 \fs15\insrsid344866 
\par }\pard \ltrpar\s19\ql \li557\ri0\sb1\nowidctlpar\intbl\wrapdefault\faauto\adjustright\rin0\lin557 {\rtlch\fcs1 \af1 \ltrch\fcs0 \fs15\cf27\insrsid2580128 Woodlands}{\rtlch\fcs1 \af1 \ltrch\fcs0 \fs15\insrsid344866 
\par }\pard \ltrpar\s19\ql \li557\ri1745\sb59\sl-142\slmult0\nowidctlpar\intbl\wrapdefault\faauto\adjustright\rin1745\lin557 {\rtlch\fcs1 \af1 \ltrch\fcs0 \fs15\cf27\insrsid2580128 Bradley Stoke Bristol}{\rtlch\fcs1 \af1 \ltrch\fcs0 \fs15\insrsid344866 
\par }\pard \ltrpar\s19\ql \li557\ri0\sb4\nowidctlpar\intbl\wrapdefault\faauto\adjustright\rin0\lin557 {\rtlch\fcs1 \af1 \ltrch\fcs0 \fs15\cf27\insrsid2580128 BS32 4JT}{\rtlch\fcs1 \af1 \ltrch\fcs0 \fs15\insrsid344866 
\par }\pard \ltrpar\s19\ql \li0\ri0\sb1\nowidctlpar\intbl\wrapdefault\faauto\adjustright\rin0\lin0 {\rtlch\fcs1 \af1 \ltrch\fcs0 \b\fs15\insrsid344866 
\par }\pard \ltrpar\s19\ql \li557\ri0\sb1\nowidctlpar\intbl\wrapdefault\faauto\adjustright\rin0\lin557 {\rtlch\fcs1 \af1 \ltrch\fcs0 \b\fs15\cf27\insrsid2580128 EMAIL}{\rtlch\fcs1 \af1 \ltrch\fcs0 \b\fs15\insrsid344866 
\par }{\field\fldedit{\*\fldinst {\rtlch\fcs1 \af1 \ltrch\fcs0 \insrsid2901607  HYPERLINK "mailto:sterilisations.msuk@nhs.net" \\h }{\rtlch\fcs1 \af1 \ltrch\fcs0 \insrsid10819794 {\*\datafield 
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c485276300000000a5ab00033a00}}}{\fldrslt {\rtlch\fcs1 \af1 \ltrch\fcs0 \fs15\cf24\insrsid2580128 sterili}}}\sectd \ltrsect\linex0\headery0\footery70\endnhere\pgbrdropt32\pgbrdrt\brdrs\brdrw20\brsp340\brdrcf24 \pgbrdrl\brdrs\brdrw20\brsp340\brdrcf24 
\pgbrdrb\brdrs\brdrw20\brsp360\brdrcf24 \pgbrdrr\brdrs\brdrw20\brsp320\brdrcf24 \sectdefaultcl\sftnbj {\field\fldedit{\*\fldinst {\rtlch\fcs1 \af1 \ltrch\fcs0 \insrsid2901607  HYPERLINK "mailto:sations.msuk@nhs.net" \\h }{\rtlch\fcs1 \af1 \ltrch\fcs0 
\insrsid10819794 {\*\datafield 
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}}{\fldrslt {\rtlch\fcs1 \af1 \ltrch\fcs0 \fs15\cf24\insrsid2580128 sations.msuk@nhs.net}}}\sectd \ltrsect\linex0\headery0\footery70\endnhere\pgbrdropt32\pgbrdrt\brdrs\brdrw20\brsp340\brdrcf24 \pgbrdrl\brdrs\brdrw20\brsp340\brdrcf24 \pgbrdrb
\brdrs\brdrw20\brsp360\brdrcf24 \pgbrdrr\brdrs\brdrw20\brsp320\brdrcf24 \sectdefaultcl\sftnbj {\rtlch\fcs1 \af1 \ltrch\fcs0 \fs15\insrsid344866 
\par }\pard \ltrpar\s19\ql \li0\ri0\nowidctlpar\intbl\wrapdefault\faauto\adjustright\rin0\lin0 {\rtlch\fcs1 \af1 \ltrch\fcs0 \b\fs16\insrsid344866 
\par 
\par 
\par 
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\tx558\wrapdefault\faauto\ls2\adjustright\rin272\lin557 {\rtlch\fcs1 \af1 \ltrch\fcs0 \fs15\cf27\insrsid2580128 We will then send your patient an email or letter so that they can call to arrange their appointment}{\rtlch\fcs1 \af1 \ltrch\fcs0 
\fs15\cf27\insrsid344866 \cell }\pard \ltrpar\s19\ql \li69\ri0\sb104\nowidctlpar\intbl\wrapdefault\faauto\adjustright\rin0\lin69 {\rtlch\fcs1 \af1 \ltrch\fcs0 \b\fs15\cf27\insrsid2580128 Patients}{\rtlch\fcs1 \af1 \ltrch\fcs0 \b\fs15\insrsid344866 
\par }\pard \ltrpar\s19\ql \li0\ri0\sb3\nowidctlpar\intbl\wrapdefault\faauto\adjustright\rin0\lin0 {\rtlch\fcs1 \af1 \ltrch\fcs0 \b\fs15\insrsid344866 
\par {\listtext\pard\plain\ltrpar \s19 \intbl\rtlch\fcs1 \af1\afs15 \ltrch\fcs0 \f1\fs15\expnd0\expndtw-1\cf27\lang1033\langfe1033\langnp1033\insrsid2580128 \hich\af1\dbch\af0\loch\f1 1.\tab}}\pard \ltrpar\s19\ql \fi-246\li562\ri142\nowidctlpar\intbl
\tx563\wrapdefault\faauto\ls1\adjustright\rin142\lin562 {\rtlch\fcs1 \af1 \ltrch\fcs0 \fs15\cf27\insrsid2580128 Patients will receive a referral email or letter from M}{\rtlch\fcs1 \af1 \ltrch\fcs0 \fs15\cf27\insrsid8027581 SI Reproductive Choices}{
\rtlch\fcs1 \af1 \ltrch\fcs0 \fs15\cf27\insrsid2580128  UK with further instructions regarding booking their treatment}{\rtlch\fcs1 \af1 \ltrch\fcs0 \fs15\insrsid344866 
\par }\pard \ltrpar\s19\ql \li0\ri0\sb2\nowidctlpar\intbl\wrapdefault\faauto\adjustright\rin0\lin0 {\rtlch\fcs1 \af1 \ltrch\fcs0 \b\fs15\insrsid344866 
\par {\listtext\pard\plain\ltrpar \s19 \intbl\rtlch\fcs1 \af1\afs15 \ltrch\fcs0 \f1\fs15\expnd0\expndtw-1\cf27\lang1033\langfe1033\langnp1033\insrsid2580128 \hich\af1\dbch\af0\loch\f1 2.\tab}}\pard \ltrpar\s19\ql \fi-246\li561\ri133\nowidctlpar\intbl
\tx562\wrapdefault\faauto\ls1\adjustright\rin133\lin561\pararsid15360596 {\rtlch\fcs1 \af1 \ltrch\fcs0 \fs15\cf27\insrsid2580128 Patients can visit our website to learn more about the procedure and what to expect.}{\rtlch\fcs1 \af1 \ltrch\fcs0 
\fs15\expnd0\expndtw-4\cf27\insrsid2580128  }{\field\fldedit{\*\fldinst {\rtlch\fcs1 \af1 \ltrch\fcs0 \insrsid2901607  HYPERLINK "http://www.MSIChoices.org.uk/" \\h }{\rtlch\fcs1 \af1 \ltrch\fcs0 \insrsid10819794 {\*\datafield 
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00030000}}}{\fldrslt {\rtlch\fcs1 \af1\afs15 \ltrch\fcs0 \fs15\ul\cf24\insrsid14301698\charrsid14301698 www.MSIChoices.org.uk}}}\sectd \ltrsect\linex0\headery0\footery70\endnhere\pgbrdropt32\pgbrdrt\brdrs\brdrw20\brsp340\brdrcf24 \pgbrdrl
\brdrs\brdrw20\brsp340\brdrcf24 \pgbrdrb\brdrs\brdrw20\brsp360\brdrcf24 \pgbrdrr\brdrs\brdrw20\brsp320\brdrcf24 \sectdefaultcl\sftnbj {\rtlch\fcs1 \af1 \ltrch\fcs0 \fs15\insrsid15360596\charrsid15360596 
\par }\pard \ltrpar\s19\ql \li0\ri0\sb2\nowidctlpar\intbl\wrapdefault\faauto\adjustright\rin0\lin0 {\rtlch\fcs1 \af1 \ltrch\fcs0 \b\fs15\insrsid344866 
\par {\listtext\pard\plain\ltrpar \s19 \intbl\rtlch\fcs1 \af1\afs15 \ltrch\fcs0 \f1\fs15\expnd0\expndtw-1\cf27\lang1033\langfe1033\langnp1033\insrsid8027581 \hich\af1\dbch\af0\loch\f1 3.\tab}}\pard \ltrpar\s19\ql \fi-245\li561\ri67\sb1\nowidctlpar\intbl
\tx563\wrapdefault\faauto\ls1\adjustright\rin67\lin561 {\rtlch\fcs1 \af1 \ltrch\fcs0 \fs15\cf27\insrsid8027581 Alternatively,}{\rtlch\fcs1 \af1 \ltrch\fcs0 \fs15\cf27\insrsid2580128 
 our clinical and support staff are available via our 24-hour vasectomy advice line to answer any clinical queries or queries about treatment options your patient may have }{\rtlch\fcs1 \af1 \ltrch\fcs0 \fs15\cf24\insrsid2580128 0345 300 0212}{
\rtlch\fcs1 \af1 \ltrch\fcs0 \fs15\expnd-1\expndtw-6\cf24\insrsid2580128  }{\rtlch\fcs1 \af1 \ltrch\fcs0 \fs15\cf24\insrsid2580128 (24hrs)}{\rtlch\fcs1 \af1 \ltrch\fcs0 \fs15\insrsid344866 \cell }\pard\plain \ltrpar
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\trftsWidth1\trftsWidthB3\trpaddfl3\trpaddft3\trpaddfb3\trpaddfr3\tbllkhdrrows\tbllklastrow\tbllkhdrcols\tbllklastcol\tblind101\tblindtype3 \clvertalt\clbrdrt\brdrs\brdrw20\brdrcf24 \clbrdrl\brdrs\brdrw20\brdrcf24 \clbrdrb\brdrs\brdrw20\brdrcf24 \clbrdrr
\brdrs\brdrw10\brdrcf24 \cltxlrtb\clftsWidth3\clwWidth3648\clshdrawnil \cellx3749\clvertalt\clbrdrt\brdrs\brdrw20\brdrcf24 \clbrdrl\brdrs\brdrw10\brdrcf24 \clbrdrb\brdrs\brdrw20\brdrcf24 \clbrdrr\brdrs\brdrw20\brdrcf24 
\cltxlrtb\clftsWidth3\clwWidth3648\clshdrawnil \cellx7397\row \ltrrow}\trowd \irow2\irowband2\lastrow \ltrrow\ts11\trrh-845\trleft101\trbrdrt\brdrs\brdrw20\brdrcf24 \trbrdrl\brdrs\brdrw20\brdrcf24 \trbrdrb\brdrs\brdrw20\brdrcf24 \trbrdrr
\brdrs\brdrw20\brdrcf24 \trbrdrh\brdrs\brdrw20\brdrcf24 \trbrdrv\brdrs\brdrw20\brdrcf24 \trftsWidth1\trftsWidthB3\trpaddfl3\trpaddft3\trpaddfb3\trpaddfr3\tbllkhdrrows\tbllklastrow\tbllkhdrcols\tbllklastcol\tblind101\tblindtype3 \clvertalt\clbrdrt
\brdrs\brdrw20\brdrcf24 \clbrdrl\brdrs\brdrw20\brdrcf24 \clbrdrb\brdrs\brdrw20\brdrcf24 \clbrdrr\brdrs\brdrw20\brdrcf24 \cltxlrtb\clftsWidth3\clwWidth7296\clshdrawnil \cellx7397\pard\plain \ltrpar
\s19\ql \li0\ri0\sb3\nowidctlpar\intbl\wrapdefault\faauto\adjustright\rin0\lin0 \rtlch\fcs1 \af1\afs22\alang1025 \ltrch\fcs0 \f1\fs22\lang1033\langfe1033\cgrid\langnp1033\langfenp1033 {\rtlch\fcs1 \af1 \ltrch\fcs0 \b\fs16\insrsid344866 
\par }\pard \ltrpar\s19\ql \li64\ri905\sb1\sl398\slmult1\nowidctlpar\intbl\wrapdefault\faauto\adjustright\rin905\lin64 {\rtlch\fcs1 \af1 \ltrch\fcs0 \b\fs15\cf27\insrsid2580128 If you have any queries contact our Vasectomy Advice Line 03
45 300 0212 (24 hours) You can also email us at }{\field\fldedit{\*\fldinst {\rtlch\fcs1 \af1 \ltrch\fcs0 \insrsid2901607  HYPERLINK "mailto:sterilisations.msuk@nhs.net" \\h }{\rtlch\fcs1 \af1 \ltrch\fcs0 \insrsid10819794 {\*\datafield 
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c485276300000000a5ab00030000}}}{\fldrslt {\rtlch\fcs1 \af1 \ltrch\fcs0 \b\fs15\cf24\insrsid2580128 sterilisations.msuk@nhs.net}}}\sectd \ltrsect\linex0\headery0\footery70\endnhere\pgbrdropt32\pgbrdrt\brdrs\brdrw20\brsp340\brdrcf24 \pgbrdrl
\brdrs\brdrw20\brsp340\brdrcf24 \pgbrdrb\brdrs\brdrw20\brsp360\brdrcf24 \pgbrdrr\brdrs\brdrw20\brsp320\brdrcf24 \sectdefaultcl\sftnbj {\rtlch\fcs1 \af1 \ltrch\fcs0 \b\fs15\insrsid344866 \cell }\pard\plain \ltrpar
\ql \li0\ri0\nowidctlpar\intbl\wrapdefault\aspalpha\aspnum\faauto\adjustright\rin0\lin0 \rtlch\fcs1 \af1\afs22\alang1025 \ltrch\fcs0 \f1\fs22\lang1033\langfe1033\cgrid\langnp1033\langfenp1033 {\rtlch\fcs1 \af1 \ltrch\fcs0 \insrsid344866 
\trowd \irow2\irowband2\lastrow \ltrrow\ts11\trrh-845\trleft101\trbrdrt\brdrs\brdrw20\brdrcf24 \trbrdrl\brdrs\brdrw20\brdrcf24 \trbrdrb\brdrs\brdrw20\brdrcf24 \trbrdrr\brdrs\brdrw20\brdrcf24 \trbrdrh\brdrs\brdrw20\brdrcf24 \trbrdrv\brdrs\brdrw20\brdrcf24 
\trftsWidth1\trftsWidthB3\trpaddfl3\trpaddft3\trpaddfb3\trpaddfr3\tbllkhdrrows\tbllklastrow\tbllkhdrcols\tbllklastcol\tblind101\tblindtype3 \clvertalt\clbrdrt\brdrs\brdrw20\brdrcf24 \clbrdrl\brdrs\brdrw20\brdrcf24 \clbrdrb\brdrs\brdrw20\brdrcf24 \clbrdrr
\brdrs\brdrw20\brdrcf24 \cltxlrtb\clftsWidth3\clwWidth7296\clshdrawnil \cellx7397\row }\pard\plain \ltrpar\s16\ql \li0\ri0\sb3\nowidctlpar\wrapdefault\faauto\adjustright\rin0\lin0\itap0 \rtlch\fcs1 \af1\afs15\alang1025 \ltrch\fcs0 
\f1\fs15\lang1033\langfe1033\cgrid\langnp1033\langfenp1033 {\rtlch\fcs1 \af1 \ltrch\fcs0 \b\fs22\insrsid344866 
\par }\pard\plain \ltrpar\s1\ql \li185\ri0\sb97\nowidctlpar\wrapdefault\faauto\outlinelevel0\adjustright\rin0\lin185\itap0 \rtlch\fcs1 \ab\af1\afs15\alang1025 \ltrch\fcs0 \b\f1\fs15\lang1033\langfe1033\cgrid\langnp1033\langfenp1033 {\rtlch\fcs1 \af1 
\ltrch\fcs0 \cf24\insrsid2580128 About our Vasectomy treatment}{\rtlch\fcs1 \af1 \ltrch\fcs0 \insrsid344866 
\par }\pard\plain \ltrpar\s16\ql \li0\ri0\sb3\nowidctlpar\wrapdefault\faauto\adjustright\rin0\lin0\itap0 \rtlch\fcs1 \af1\afs15\alang1025 \ltrch\fcs0 \f1\fs15\lang1033\langfe1033\cgrid\langnp1033\langfenp1033 {\rtlch\fcs1 \af1 \ltrch\fcs0 \b\insrsid344866 

\par }\pard \ltrpar\s16\ql \li185\ri410\sb1\sl244\slmult1\nowidctlpar\wrapdefault\faauto\adjustright\rin410\lin185\itap0\pararsid811780 {\rtlch\fcs1 \af1 \ltrch\fcs0 \cf27\insrsid2580128 
If you or your patient wishes to learn more about the vasectomy procedure or have any questions. Please }{\rtlch\fcs1 \af1 \ltrch\fcs0 \cf27\insrsid9705413 view the va}{\rtlch\fcs1 \af1 \ltrch\fcs0 \cf27\insrsid2580128 sectomy information }{\rtlch\fcs1 
\af1 \ltrch\fcs0 \cf27\insrsid9705413 on our }{\rtlch\fcs1 \af1 \ltrch\fcs0 \cf27\insrsid2580128 website }{\field\fldedit{\*\fldinst {\rtlch\fcs1 \af1 \ltrch\fcs0 \insrsid2901607  HYPERLINK "http://www.MSIChoices.org.uk/" \\h }{\rtlch\fcs1 \af1 
\ltrch\fcs0 \insrsid10819794 {\*\datafield 
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00030000}}}{\fldrslt {\rtlch\fcs1 \af1\afs16 \ltrch\fcs0 \fs16\ul\cf24\insrsid2580128\charrsid424923240 www.}{\rtlch\fcs1 \af1\afs16 \ltrch\fcs0 \fs16\ul\cf24\insrsid9705413 MSIChoices}{\rtlch\fcs1 \af1\afs16 \ltrch\fcs0 
\fs16\ul\cf24\insrsid2580128\charrsid424923240 .org.uk}}}\sectd \ltrsect\linex0\headery0\footery70\endnhere\pgbrdropt32\pgbrdrt\brdrs\brdrw20\brsp340\brdrcf24 \pgbrdrl\brdrs\brdrw20\brsp340\brdrcf24 \pgbrdrb\brdrs\brdrw20\brsp360\brdrcf24 \pgbrdrr
\brdrs\brdrw20\brsp320\brdrcf24 \sectdefaultcl\sftnbj {\rtlch\fcs1 \af1\afs16 \ltrch\fcs0 \fs16\ul\cf24\insrsid7108173\charrsid424923240  }{\rtlch\fcs1 \af1 \ltrch\fcs0 \cf27\insrsid2580128 or call us on }{\rtlch\fcs1 \af1\afs16 \ltrch\fcs0 
\fs16\cf24\insrsid2580128\charrsid424923240 0345 300  0212}{\rtlch\fcs1 \af1\afs16 \ltrch\fcs0 \fs16\insrsid344866 
\par }\pard \ltrpar\s16\ql \li0\ri410\sb7\nowidctlpar\wrapdefault\faauto\adjustright\rin410\lin0\itap0\pararsid811780 {\rtlch\fcs1 \af1 \ltrch\fcs0 \fs10\insrsid344866 
\par }\pard\plain \ltrpar\s1\ql \li185\ri410\sb96\nowidctlpar\wrapdefault\faauto\outlinelevel0\adjustright\rin410\lin185\itap0\pararsid811780 \rtlch\fcs1 \ab\af1\afs15\alang1025 \ltrch\fcs0 \b\f1\fs15\lang1033\langfe1033\cgrid\langnp1033\langfenp1033 {
\rtlch\fcs1 \af1 \ltrch\fcs0 \cf24\insrsid2580128 About M}{\rtlch\fcs1 \af1 \ltrch\fcs0 \cf24\insrsid15034966 SI Reproductive Choices }{\rtlch\fcs1 \af1 \ltrch\fcs0 \cf24\insrsid2580128 UK}{\rtlch\fcs1 \af1 \ltrch\fcs0 \insrsid344866 
\par }\pard\plain \ltrpar\s16\ql \li0\ri410\sb3\nowidctlpar\wrapdefault\faauto\adjustright\rin410\lin0\itap0\pararsid811780 \rtlch\fcs1 \af1\afs15\alang1025 \ltrch\fcs0 \f1\fs15\lang1033\langfe1033\cgrid\langnp1033\langfenp1033 {\rtlch\fcs1 \af1 \ltrch\fcs0 
\b\insrsid344866 
\par }\pard \ltrpar\s16\ql \li185\ri410\sl252\slmult1\nowidctlpar\wrapdefault\faauto\adjustright\rin410\lin185\itap0\pararsid811780 {\rtlch\fcs1 \af1 \ltrch\fcs0 \cf27\insrsid2580128 
We are an independent, specialist reproductive healthcare provider of NHS-funded and private treatment in the UK. Through our network of centres and clinics we are able to help over 70,000 patients each year. We are part of the world\rquote 
s leading reproductive charity, M}{\rtlch\fcs1 \af1 \ltrch\fcs0 \cf27\insrsid11744606 SI Reproductive Choices}{\rtlch\fcs1 \af1 \ltrch\fcs0 \cf27\insrsid2580128 , who provides a full range of quality sexual and reproduct
ive health services to women and men in some of the }{\rtlch\fcs1 \af1 \ltrch\fcs0 \cf27\insrsid10644461 world\rquote s poorest}{\rtlch\fcs1 \af1 \ltrch\fcs0 \expnd1\expndtw6\cf27\insrsid2580128  }{\rtlch\fcs1 \af1 \ltrch\fcs0 \cf27\insrsid2580128 
communities.}{\rtlch\fcs1 \af1 \ltrch\fcs0 \insrsid344866 
\par }\pard \ltrpar\s16\ql \li185\ri410\sb132\nowidctlpar\wrapdefault\faauto\adjustright\rin410\lin185\itap0\pararsid811780 {\rtlch\fcs1 \af1 \ltrch\fcs0 \cf27\insrsid2580128 For more information including maps and directions to all our centres visit the M}{
\rtlch\fcs1 \af1 \ltrch\fcs0 \cf27\insrsid2957732 SI Reproductive Choices}{\rtlch\fcs1 \af1 \ltrch\fcs0 \cf27\insrsid2580128  UK website}{\rtlch\fcs1 \af1 \ltrch\fcs0 \cf27\insrsid2957732  }{\field\fldedit{\*\fldinst {\rtlch\fcs1 \af1 \ltrch\fcs0 
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