the centre for
Anaesthesia
Director: Prof Monty Mythen
UCL
Physics + Clinical Measurement
for the Primary FRCA
A series of 7 evening sessions at UCLH
Name
Address
Email
Mobile phone

How many months of anaesthesia experience have you had?

What year did you qualify from medical school?

Have you taken the Primary FRCA before?

Meal requirements: Meat / Vegetarian / Vegan / other

How did you find out about the course?
Thanks for filling in this form.
We’ll be in touch.
Please send a £60 cheque (payable to “UCLH special trustees” account 1062)
and this completed form to:
Mrs Alison Lambert
Anaesthetics Department
Podium 3, Maple Link corridor
University College Hospital
235 Euston Road
London
NW1 2BU