REGISTRATION Organised Evidence Based Care : Diabetes
Broken Hill and Dubbo Workshops | May, August, October 2023

The learning series adopts an incremental and practical approach to learning and improvement comprising:

· two face-to-face workshops, entitled Start up and Step up

· one online workshop entitled Sustainability

· group coaching – to support your CQI journey and facilitate action learning.

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* Your details

Full Name

Primary workplace

Town

Preferred Email Address

Mobile Number

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* Profession:

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* I would like to attend the following workshops:

Broken Hill (9 May, 1 August, 10 October)

Dubbo (10 May, 2 August, 12 October)

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* Do you have any special dietary requirements?

Yes (please provide details below)

Please list special dietary requirement(s):

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* Do you identify as Aboriginal or Torres Strait Islander?

Yes

Prefer not to say

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* 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 regarding this event and their other services. You also consent to being photographed by WNSW PHN and our identified event partner Prestantia Health. Any material may then be used for online, social media, marketing or promotional purposes. If you do not consent to the above, please email cpd@wnswphn.org.au prior to the event date - please mark email as 'Urgent' and state your request not to be photographed/recorded

I consent

I do not consent (please email cpd@wnswphn.org.au prior to the event)

Thank you for supporting this WNSW PHN education activity

We look forward to welcoming you to this progressive learning series.

Your assistance in sharing the event flyer with relevant colleagues working in your practice team is appreciated.

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100% of survey complete.