Survey to gauge interest in future modules

Please tell us about yourself as we have to demonstrate what sort of people might be interested in order to be allowed to apply to run a module.
Then let us know which, if any, of the modules you might be interested in.
There is NO commitment from completing this survey - it is purely a fact finding exercise.
We will let you know the outcome of the application process so that you can decide if you want to take the idea any further.
Thank you for taking part.
Karen Groves
education@queenscourt.org.uk

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* 1. Please tell us your full name

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* 2. What is your profession? (e.g. nurse, doctor, physio etc.)

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* 3. What role are you currently working in? (e.g. ward staff nurse, community physio, GP etc.)

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* 4. Which organisation do you currently work for?

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* 5. Where is your place of work? (e.g. Ward X AUH, Formby Neighbourhood Team, Gables Nursing Home, Brighton Hospice etc.)

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* 6. Please indicate which of the following modules would interest you? (You can choose as many as you like)

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* 7. If there is anything else you would like to suggest please do so here

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* 8. At what email address would you like to be contacted?

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