First Name

Second Name

Email Address

Phone Number

Address

Session Date

Booking Type Booking TypeOnline TutorialOne to One TutorialGroup TutorialTraining Session (University Based)Training Session (Public Sector)GP Reception Workshop

I understand that for online tutorials a webcam, Skype or FaceTime and broadband internet connection are required.

Educational Institution

Company

Session Venue

Practice Name

Number of participants

Do you require facilitation provided by Procommskills for the workshop? Do you require facilitation provided by Procommskills for the workshop? Please provide facilitation We will provide our own facilitation Unsure

Do you require scenarios providing for the workshop? Do you require scenarios providing for the workshop? We will provide our own scenarios We would like to use the standard scenarios provided by Procommskills We would like bespoke scenarios creating to meet our spesfic learning requirments Unsure

Would you like to include an interactive demonestration as part of the workshop? Would you like to include an interactive demonestration as part of the workshop? Yes No Unsure

Session Requirements