UCL MEDICAL SCHOOL Department of Primary Care and Population Health Community Based Teaching Care of the Older Person - September 2013 to July 2014 Wednesday & Thursday 9.30-12.30 Placement 1 Placement 2 Placement 3 WED THUR WED THUR WED THUR 25 Sep 2 Oct 9 Oct 16 Oct 26 Sep 3 Oct 10 Oct 17 Oct 23 Oct 30 Oct 6 Nov 13 Nov 24 Oct 31 Oct 7 Nov 14 Nov 20 Nov 27 Nov 4 Dec 11 Dec 21 Nov 28 Nov 5 Dec 12 Dec Placement 4 WED 8 Jan 15 Jan 22 Jan 29 Jan Placement 5 THUR 9 Jan 16 Jan 23 Jan 30 Jan WED 5 Feb 12 Feb 19 Feb 26 Feb Placement 7 WED 9 Apr 16 Apr 30 Apr 7 May THUR 10 Apr 24 Apr 1 May 8 May THUR 6 Feb 13 Feb 20 Feb 27 Feb Placement 8 WED 14 May 21 May 28 May 4 Jun THUR 15 May 22 May 29 May 5 Jun Placement 6 WED 5 Mar 12 Mar 19 Mar 26 Mar THUR 6 Mar 13 Mar 20 Mar 27 Mar Placement 9 WED 11 Jun 18 Jun 25 Jun 2 Jul THUR 12 Jun 19 Jun 26 Jun 3 Jul We can commit to leaching on the dates indicated above (please tick) Name & address of practice Name(s) of tutor(s) who will be teaching COOP Number of students I can take (4-6) Signature: Date: Please return this form ASAP either by email carol.lynch@ucl.ac.uk, fax (020 7472 6871) or by post to the address below Carol Lynch Dept. of Primary Care & Population Health, UCL Medical School, Royal Free Campus, Rowland Hill Street, London NW3 2PF