Making the Move Booking Form – Leeds, 8th June 2019

Making the Move Booking Form – Leeds, June 8th 2019

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

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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 8th June – GPs (11am to 1pm)

Saturday 8th June – Consultants (3pm to 5pm)

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* 4. Are you a GP or Consultant?

GP

Consultant

Other (please specify)

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* 5. If you are a Consultant, what is your speciality area?

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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

Canada

Maldives

Other (please specify)

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* 7. Where did you hear about our event?
(e.g. email, BMJ, Doctors.Net, Pulse, Facebook, Google search, referred by a friend...)