SuppoRTT Course Application - The Health Academy

Get in touch:

If you have any queries or problems with your application, please contact the team:

Email: suppoRTT@lthtr.nhs.uk
Telephone: 01257 245371

"*" 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?*

Which date would you like to attend?

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. If this is the case, please state NOT REQUIRED.

Please indicate if you would like to attend Day 3*

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 3 is not suitable for you. If this is the case, please state NOT REQUIRED.

How did you hear about this course?*

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.

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