You will need to print this form off and send
to address below
| name |
........................................................................ |
| address |
........................................................................
........................................................................
........................................................................ |
| email |
........................................................................ |
| telephone |
........................................................................ |
| post (please ring) |
staff grade associate specialist
other (specify).............. |
| medical speciality |
........................................................................ |
I want to come to the first meeting (please ring) later this
year
|
yes / no (will
be a Saturday morning, probably in Birmingham) |
| the first aim of the group should be |
........................................................................
........................................................................
........................................................................
|
| the second aim of the group should be |
........................................................................
........................................................................
|
| the third aim of the group should be |
........................................................................
|
| the main problem with the new contract for me is |
........................................................................
........................................................................
........................................................................
|
| the second problem with the new contract for me is |
........................................................................
........................................................................
|
the third problem with the new contract for me is
|
........................................................................ |
David Kinshuck,
National Staff Grade and Associate Specialist Group,
Eye Department,
Good Hope Hospital,
Rectory Rd,
Sutton Coldfield, B75 7RR
email queries etc to david.kinshuck (at) heartofengland.nhs.uk (replace
(at) with @)
|