Name

Position

Hospital

Email Address

Mobile Number

Please select the Course(s) you would like to attend ( We recommend that if you have no ultrasound experience then you also attend the dedicated US course in Stanmore Or Manchester) Please select the Course(s) you would like to attend ( We recommend that if you have no ultrasound experience then you also attend the dedicated US course in Stanmore Or Manchester) 7th October - Stanmore (US course) 7th October - Manchester (US course) 12th October - London (Practical Training) 13th October - Manchester (Practical Training) 25th November - Birmingham (Practical Training ) 9th December - Bristol (Practical Training)

Do you have any Allergies? Do you have any Allergies? Yes No

Allergies