Registration Form

Assistant Practitioners Study Day

A 1 day course suitable for assistant practitioners - training or qualified.

Topics to include:-

  • Live technique demonstration
  • Imaging technology
  • Post diagnosis options
  • Family history
Personal Details
Title  
Forename  
Surname  
Job Title  
Work Details
Do you work within the NHS?  
Name  
Address Line 2  
Address Line 3
Address Line 4
Address Line 5 Post Code  
Daytime no.  
Mobile no.
Email address  
Special dietary access requirements
Payment Details
Registrations: Payment must be received to secure a place fully. Please send a cheque payable to ‘Nottingham University Hospitals’ with this form or contact the education office (Tel 0115 969 1689) to make a credit card payment. Alternatively, please supply a purchase order number together with invoice contact details and address. Failure to do so, will mean other bookings will take precedence.
Payment method  
Please send payment to:

Blamey Education Centre
Nottingham Breast Institute
City Hospital Campus
Hucknall Road
Nottingham NG5 1PB
Data protection:

We may share limited delegate information with people involved in delivering the course. We will not pass on or sell database information to any third party.

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