Cultural Diversity and Palliative Care

HEALTH LITERACY AND PALLIATIVE CARE

Wed 11 Nov 2pm – 2:50pm

Please complete the details below. Your registration will be confirmed asap.

Please note: only the first 12 people who register will get a place. You will be notified asap to inform if you have been successful.
You will also be sent notification if unsuccessful and if interest in the sessions exceed capacity, you will be offered a session in the near future.

If you have any questions regarding this webinar please contact tanja.bahro@smrpcc.org.au

Thank you.

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* 1. What is your name?

First name

Last name

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* 2. Where do you work?

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* 3. Which best describes your profession?

Nursing

Medical

Allied Health

Other (please specify)

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* 4. At what email address would you like to be contacted?

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* 5. What is the best phone number to contact you?
PLEASE NOTE: We will only contact this number if there are last minute changes or if we experience difficulties with your email address.

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* 6. Would you like to receive the SMRPCC's monthly email update?

Yes, please email to the address provided at Q.5

No, thank you

I already receive the update

Yes, please email to:

Question Title

* 1. What is your name?

Question Title

* 2. Where do you work?

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* 3. Which best describes your profession?

Question Title

* 4. At what email address would you like to be contacted?

Question Title

* 5. What is the best phone number to contact you? PLEASE NOTE: We will only contact this number if there are last minute changes or if we experience difficulties with your email address.

Question Title

* 6. Would you like to receive the SMRPCC's monthly email update?

* 5. What is the best phone number to contact you?
PLEASE NOTE: We will only contact this number if there are last minute changes or if we experience difficulties with your email address.