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Apologies for the long form in advance, but we would be grateful if you would take the time to complete it; by doing so we can ensure we only send relevant information to you and your organisation.
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Please select the most appropriate or if you are not sure, or the option isn't listed, select Other and we will enter this information for you.
e.g. Mickey Mouse Surgery, Pluto Health Centre etc...
Please provide a contact number, in case we needed to make contact out of office hours (e.g. course postponement etc...)
If you are not sure, don't worry, we will enter this information for you.
Please select your Health Board, Area or County e.g. C & V (Cardiff & Vale), EAL (Ealing), GLO (Gloucestershire), SWI (Swindon) etc... if you are not sure, or the option isn't listed, select Other and we will enter this information for you.
e.g. Nurse, HCA, Practice Manager, Receptionist etc...
Please select the most appropriate option or if you are not sure, or the option isn't listed, select Other and we will enter this information for you..

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