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Russell : I don't think I can. Riversdale Surgery, 59 Bridge Street, Belper, DE56 yal Primary Care Clay Cross Grassmore, Eldon Street, Clay Cross, Chesterfield, S45 wley Medical Centre, 60 Draycott Road, Sawley, Long Eaton, NG10 3FRSett Valley Medical Centre, Hyde Bank Road, New Mills, High Peak, SK22 ires Health Care Church. Hartington Surgery, Dig Street, Hartington, Buxton, SK17 0AQHasland Medical Centre, 1 Jepson Road, Hasland, Chesterfield, S41 0NZ. Swadlincote Surgery, Darklands Road, Swadlincote, DE11 0PP.

Gender male, female Sexual Orientation* Gay Lesbian Bisexual Heterosexual/Straight Other Relevant Information* Select other relevant informationNoneMobility ProblemsPhysical DisabilityDementia/Memory ProblemsDependant ChildrenCarer ResponsibilitiesDifficulty Reading and WritingRequire a TranslatorWheel Access Required For which language do you require a translator?* Are you currently pregnant? Just before closing time he picks up Glen but what's expected to be just a one-night stand becomes something else, something special. Yes, no, by ticking yes you are providing your consent for Trent PTS to contact you this way. Blackwell Medical Practice, 6 Gloves Lane, Blackwell, Alfreton, DE55 ailsford Medical Centre, The Green, Brailsford, DE6 imington Surgery, Church Street, Brimington, Chesterfield, S43 ook Medical Centre, 183 Kedleston Road, Derby, DE22 ooklyn Medical Practice, 65 Mansfield Road, Heanor, DE75 xton Medical Practice, 2 Temple Road. Address do you give your consent for us to contact you at this address? Parties, pubs, outings, entertaining etc.* 0 Not at all 1 2 Slightly 3 4 Definitely 5 6 Markedly 7 8 Very Severely I Cannot Work private leisure activities - Done alone,.g.

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