CPD EVENT REGISTRATIONWNSWLHD ADHD & Behavioural Management Pilot and Co Management Support2024 & 2025RACGP Activity No. 956488 Survey

1.Your details(Required.)

Full Name

Primary workplace

Town

Preferred Email Address

Mobile Number

2.Profession:(Required.)

3.Which session do you wish to attend?(Required.)

Bathurst 20 August 2024

Orange 21 August 2024

Mudgee 21 October 2025

Parkes 22 October 2025

4.Do you have any special dietary requirements?(Required.)

Yes (please provide details below)

N/A (virtual event)

Please list your special dietary requirement(s):

5.Do you identify as Aboriginal or Torres Strait Islander?

Yes

Prefer not to say

6.By checking this box you submit your information to the Western NSW Primary Health Network (WNSW PHN), as the event organiser, who will use it to communicate with you via relevant registration and distribution lists regarding this event and other services. You also consent to being filmed, photographed and/or recorded by WNSW PHN and/or our identified event partner(s). Any recorded material may then be used for online, social media, marketing or promotional purposes.
(Required.)

I consent

I do not consent (please email cpd@wnswphn.org.au prior to the event stating your request NOT to be photographed/recorded). Please also email this address if you wish to UNSUBSCRIBE from the Education Program's distribution lists)

Thank you for supporting this
Western NSW Primary Health Network (WNSW PHN)
education activity

Registrations will remain open until 7 days prior to the meeting date, unless capacity is reached beforehand.

We look forward to welcoming you to this event

Your assistance in sharing the event flyer with relevant colleagues and communication networks is appreciated.