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Website Fault Report
Your name
*
Your email address
*
Your phone number
Practice name
Fault Details
URL of the page that has issues
*
Describe the issue
*
Screenshots of the issue
Image
1
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Do you have a stable internet connection?
*
Yes
No
Is this issue happening on a particular device only?
*
Yes
No
Have you tried other browsers?
*
Yes
No
Where are you experiencing this issue?
*
Mobile
Desktop
Both
What device did you use?
*
Which browser did you use?
*
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