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1. Please enter your name and the practice you work in

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2. Which student years do you teach?

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3. Are you a training practice?

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4. Do you have a special interest?

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5. Are any specialist clinics run in your practice?

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6. Would you be interested in a peer observation session of your teaching?

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7. Please write any comments on how the department can support you best and any ideas you have to improve the communication between us and yourselves

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