Test - The Health Academy

TEST PAGE FOR SuppoRTT

SUPPORTT Course Registration (TEST)

"*" indicates required fields

Name*

Prefix First Last

(As registered)

Preferred badge name*

Primary Contact Number*

Alternative Contact Number*

Email*

If you do not have regular access to your work email, please include your personal email

Healthcare Professional Registration Number*

ie. GMC / NMC / HPC

Grade*

Speciality*

National Training Number*

Name of the Trust you are returning to*

Return to work date*

Please provide actual return to work date including any accrued A/L

Length of time out of training*

Reason for time out of training*

Are you returning to a patient facing role?*

Day 2 of the course is hands on simulation training and may not be suitable if you are returning to a non-patient facing role.

Is this your first NHS role?*

Please specify any dietary/other requirements for face-to-face training*

If you require any additional support or alternative access on the day, please specify what you will need and a member of the team will contact you to discuss.

Which date do you wish to attend*

This is an online webinar delivered via zoom and places will be confirmed subject to availability. The day is usually split into 2 session 10.00-12.00 and 13.00 - 15.00 and if childcare is an issue, we understand that sometimes children will need to be on the call with you.

Please indicate if you would like to attend Day 2?*

Please visit following website for an overview of what is covered on each of the SuppoRTT days. https://www.nwpgmd.nhs.uk/nw-supportt-course Depending on your specialty, grade, place of work and personal circumstances you may feel Day 2 is not suitable for you.

How did you hear about this course?*