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NHS Ayrshire & Arran Diabetes Patient Information & Awareness Session - Cumnock Town Hall Wednesday 9th September 2026

Page 1

Cumnock Town Hall 

9th September 2026 

10am - 12 noon 

Please use this form to book your space. 

Question 1.

First Name

Question 2.

Surname

Question 3.

Address:

Question 4.

Postcode

Question 5.

Telephone Number

Question 6.

Email Address

Question 7.

Do you have any special requirements?

Question 8.

What do you hope to gain from the Diabetes Information and Awareness session?

Question 9.

Is there anything else you would like us to know before the day?

Question 10.

Please read the following and if you agree, please give your consent by ticking the box below.