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Application Form

Please read the form carefully - Please ensure you are able to attend your most preferred option.
We will be in touch within the next 7-10 days with confirmation of place allocation. Please contact nisha.patel16@nhs.net for any further questions

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* 1. Full name

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* 2. Email address

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* 3. Job title

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* 4. How long have you been in your current post?

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* 5. Organisation name

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* 6. Organisation type

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* 7. Borough

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* 8. Name of PCN (if applicable)

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* 9. Please choose your most preferred programme option

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* 10. What are you hoping to get from the session?

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* 11. The training will be held via MS Teams with regular breaks.  Please can you let us know if there are any additional/accessibility needs that may be required.

Data will be processed in accordance with our Privacy Notice, which can be accessed here.
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