Please confirm name of GP Practice you are mainly based *
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Please confirm name of PCN you are mainly based in *
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Please use this space to tell us of other roles you are undertaking at present eg. PCN Clinical Director
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Please confirm which Borough you work in *
Required
Please state how you completing this programme will improve patient care *
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Please state how completing this training will support your Personal Development *
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Please tell us a bit about your experience in Leadership and Management in your career so far
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Please confirm level of qualification you currently hold *
I am aware that this programme is investing over £2500 per learner. And confirm that I can fully commit to the programme to include the dedicated self study time. *
Required
I can also confirm I have full support from my employer/business partners to undertake the programme *