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Full Name*

First Name Last Name

Phone Number*

- Area Code Phone Number

Email

I am seeking care for

I would like to:

Have a consultation with Dr. Tukmachi Schedule my appointment to get help NOW ASAP Please send me your Confidential New Patient Health Forms I’ll complete the form at your Clinic on my appointment date

Choose your convenient date and time for your next appointment

/ Month / Day Year

at

: Hour Minutes

Which Nuffield Hospital clinic you would prefer?

First Time choice at Newcastle-u-Lyme Nuffield Hospital (Monday & Thursday)

8AM—10AM 12PM—2PM 4PM—7.30PM

Second Time choice at Wolverhampton Nuffield Hospital (Tuesday & Friday)

10AM—12PM 12PM—2PM 3PM—5PM

Third Time Choice at Derby Nuffield Hospital (Tuesday & Friday)

8.30AM—2.30PM

The fourth clinic choice at London - Harley Street (Saturday)

1.0PM—2.30PM 3PM—5.30PM 6PM—8PM

The fifth clinic choice at Manchester - Didsbury (Wednesday)

1.0PM—2.30PM 3PM—5.30PM 6PM—8PM

Please notify me of my appointment confirmation by:

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Contact-Us - UK Acumedica

If you have any queries or would like further information about acupuncture, please complete the form below and we’ll call you back as soon as possible (within normal working hours).