A skills-based training program for general practice on caring for patients who use alcohol and other drugs  

Thank you for expressing your interest in completing the 'Caring for patients who use alcohol and other drugs: a skills-based training program for general practice' workshop and follow-up-webinar.
Please complete this form by 5pm AEDT on Friday, 11 August 2023
If you have any queries, please contact education@nwmphn.org.au
1.What is your full name?(Required.)
2.What is your occupation?
3.Which general practice do you work for?(Required.)
4.What is the address of your general practice?(Required.)
5.What is your preferred email address? Please note that this can't be a shared email address.(Required.)
6.What is your preferred contact number?(Required.)
7.I confirm that I am a GP or practice nurse located in the NWMPHN region(Required.)
8.I confirm that I will attend both the face-to-face workshop and the follow-up webinar(Required.)
9.Provide 100-200 words explaining why you would like to participate in this training(Required.)
10.Provide 100-200 words describing how your patients will benefit from you undertaking this training(Required.)
11.Please provide any additional information to support your application