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Dr. Suzanne Taylor
General Practitioner
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Request a Workplace Wellness Session
Company Name
*
Company Address (and Location of Session if it is different)
*
Proposed Date of session
*
Number of staff to participate in Group session
*
Preferred Topic
*
Number of staff to participate in Individual Consultations
*
Add-On extra Individual Consultations?
*
No
+6
+12
The Individual Consults will be
*
Quick Consults/Basic Personal
Basic Work Medicals
You understand that your location must have a space/room for the seated group session (conducive to a video presentation). You understand that your location must also have a private room for the individual consultations and a hand-washing station/sink.
*
Yes
Main Contact For Your Company (Please state Name, Job Title, Phone Number & Email Address below)
*
Submit Request
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