{"text":"NHS$ Cenfidential: Parsonal dala about a patlent \nPart 5: Condition Management Programme not completed (1 \ncompleted by the customer or provider as appropnate) L, \nCustomer withdraws consent \u2018 \u2019 \n* Inolonger wish to padlmpate in the NHS-Condition Management Programrne \nas from \nCustomer's signature Date \nP _ \ne - \nCustomer does not attend programme \nThe customer has not attended for weels without explanation. Participation in the \nprogramme s deerned to have been withdrawn. \nProvider's signature ' Date \ni . . \n! Customer does not complete the programme \nThe customer has not fully completed the programme for the reasons given below. Of the \nweeks in the programme the customer participated for weeks. \nProvider's s;gnature . Date \nTTE =T o B S S e A . - e \nReasons . \nl | \n! \nL e e -~ - \nIRRMAPD Page 2 of 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