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APPLICATION FORM FOR CXR ABNORMALITIES - What do I do Next?
Please complete this form to confirm attendance at this course.
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Email
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Your email
Surname
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Your answer
First Name
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Your answer
Are you
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A Diagnostic Radiographer with Reporting Responsibilities
A Diagnostic Radiographer without Reporting Responsibilities
An Assistant Practitioner
Required
Contact Number
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Your answer
Which Trust do you work for
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Alder Hey Children's NHS FT
Blackpool Teaching Hospital NHS FT
Bolton NHS FT
Countess of Chester Hospital NHS FT
East Cheshire NHS Trust
East Lancashire Hospitals NHS Trust
Lancashire Teaching Hospitals NHS Trust
Liverpool Heart and Chest Hospital NHS FT
Liverpool University Hospitals NHS FT
Liverpool Women's NHS FT
Manchester University FT
Mid Cheshire Hospitals NHS FT
Northern Care Alliance NHS FT
Southport and Ormskirk Hospital NHS Trust
St Helen's and Knowsley Teaching Hospitals NHS FT
Stockport FT
Tameside and Glossop Integrated Care NHS FT
The Christie NHS FT
The Clatterbridge Cancer Centre NHS FT
The Walton Centre NHS FT
University Hospitals of Morecambe Bay NHS FT
Warrington and Halton Teaching Hospitals NHS FT
Wirral University Teaching Hospitals NHS FT
Wrightington, Wigan and Leigh NHS FT
Required
Name of Radiology Clinical Manager
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Your answer
Email Address of Radiology Clinical Manager
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Your answer
Please note your place is being funded by NHSE, and your line manager is assuring that you are able to attend, if for any reason you are unable, your line manager must confirm the reason for non attendance. Places on these courses are of high value and when possible, early notification of a change in your circumstances resulting in you being unable to attend would be welcomed to allow your place to be released to someone on the waiting list. NHSE will be informed of People/Trusts who repeatedly fail to attend booked courses and will be unlikely to be accepted onto future courses.
Please tick below to confirm you agree to these terms and conditions and have your line managers approval to attend.
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A copy of your responses will be emailed to the address you provided.
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