GDPR Consent Form

Please review the GDPR data protection policy here and check the box to say that you have read and understood it

Privacy statement

Please tick the boxes below to give me permission to use the information you have supplied in the following ways:

I understand that I can, at any time, request that my personal information not be used for these purposes by contacting:

Kirstie Anne Wellbeing


While I remain a patient of Kirstie Anne Wellbeing (and for seven years thereafter), I consent to my personal information being used for the purposes detailed above.