Making the Move Booking Form – London October 2017

Making the Move Booking Form – London October 2017

Complete this form in order to book your place at one of our upcoming Making the Move sessions in London.

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* 1. Please complete your contact details

Name: *

Email Address: *

Phone Number:

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* 2. If you wish to attend with a partner/friend/colleague, please provide their name and occupation.

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* 3. Which session would you like to attend?

Saturday 28th October – Consultants (10:30am to 12:30pm)

Saturday 28th October – GPs (2pm to 4pm)

Sunday 29th October – Consultants/GPs combined session (12pm to 2pm)

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* 4. Are you a GP or Consultant?

Consultant

General Practitioner

Other (please specify)

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* 5. If you are a Consultant, please tell us your specialty:

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* 6. Which location/s are you interested in learning more about during the event?

Australia

New Zealand

Qatar

Saudi Arabia

UAE

Singapore

China

Caribbean

Maldives

Other (please specify)

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* 7. Where did you hear about our event?
(e.g. email, BMJ, Drs net, Pulse, Facebook, google search, referred by friend)