Are you, or have you ever been, a patient of ours?

YesNo

I am happy for Leek Osteopathic Health Centre to record my personal data:

YesNo

I am happy to receive Marketing material from the practice (This may consist of the following Promotional offers/Newsletters/Birthday/Xmas Voucher/Event information)

YesNo

You can change your mind at any time by clicking the unsubscribe link in the footer of any email you receive from us, or by contacting us at [email protected]. We will treat your information with respect. For more information about our privacy practices please visit our website. By clicking below, you agree that we may process your information in accordance with these terms.

We use MailChimp as our marketing automation platform. By clicking below to submit this form, you acknowledge that the information you provide will be transferred to MailChimp for processing in accordance with their T&Cs and our Privacy Policy and Terms.