PDA Covid-19 vaccination taskforce registration

Please provide your details if you would like the PDA to share your information with relevant organisations within the NHS to express your interest in being contacted about supporting the Covid-19 vaccination programme.

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* 1. Please tell us your name

First Name

Surname

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* 2. What is your GPhC/PSNI number?

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* 3. What is your contact telephone number?

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* 4. What is your email address?

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* 5. Are you trained to deliver Covid-19 vaccinations in accordance with the government training recommendations?

Yes

No