Home News Contact Us Menu Home News Contact Us 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 YourselfSomeone else Name* First NameLast Name Date of birth* -Day -MonthYearDate 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: