Booking Form

* Repeat the CAPTCHA word above

* Course

Additional course 1

Additional course 2

* Your Name

* Role / Job Title

NMC/GMC PIN (If applicable)

* Your Email

* Your Phone

* Practice / Base

* Address

* Name and Discipline of Budget Holder

* Email Address of Budget Holder

Paying Authority if not the Practice?

How did you hear about us?

By submitting this form I acknowledge I have read and accept the Privacy Policy

Starting Wednesday 29, Jan

BASINGSTOKE, The Willis Museum

Starting Wednesday 5, Feb

HUNTINGDON - Hemingford Pavilion

Starting Wednesday 19, Mar

CHANDLERS FORD - The Kings Court Centre