Home News Opening Hours Contact Us Menu Home News Opening Hours Contact Us Search Search Albion Medical Practice Ask your doctor a questionPlease use this form to get in contact with your doctor, we aim to respond within 2 working days. Are you completing this form on behalf of Yourself Someone else Name * First Name Last Name Date of birth * - Day - Month Year Date Telephone number * Email * example@example.com Please tell us about the problem * How long have you had this problem? * * I confirm that this problem is not an emergency. I understand that the practice will not deal with this problem while the practice is closed. Submit Should be Empty: