P-CNS Registration
To register your interest in joining the P-CNS and also
attending future Primary Care Neurology Society conferences
please complete this pre-registration form. * = Required |
| Name of your organisation |
|
| Note: When accesssing some of the resources
on this site you will be asked for your e-mail address and
password. |
| If you are a healthcare professional please
state which profession e.g. GP, Practice Nurse, Consultant
Neurologist, Physiotherapist etc: |
| If you work in the PCT offices, please indicate
your job title: |
| If you work in Social Services please state
your job title: |
| If you work in the voluntary sector please state
name of your organisation and your position: |
| Particular neurological condition relevant to
you: |
|
| If the neurological condition relevant to you
is not listed above please provide us with the information
in the following box: |
| Please provide details of any projects (research
or otherwise) in neurology care that you are currently involved
with or planned to participate in: |
| Current educational in neurology: e.g. GP tutor |
| Have you ever published research papers/articles
in primary care journals on neurology? |
| If yes, please provide details: |
| Other Relevant information that you would like
to provide the P-CNS: |
| I am happy for the details I have provided to
be held on the P-CNS database with the understanding that
no data will be released without the permission of the Executive
Council. If you do not agree, please tick
this box
|
| From time to time we may send you additional
information on the services and products of Innervate Ltd,
the secretariat for the P-CNS. If you do not wish
to receive information please tick this box
|
| From time to time we may send you additional
information on the services and products of organisations
associated with P-CNS. If you do not wish
to receive information please tick this box
|
