Booking Form - Birmingham Children`s Hospital

Booking Form
Stabilisation of the Critically Ill Child
Study Day
(ONLY 30 Places – 15 medical (Anaesthesia/ Paediatrics/ Emergency) 15 Nurses/
Date: (Please specify)
Hospital and Department:
Job Title:
Telephone No and address:
Dietary considerations:
Course Date:
Method of Payment:
With only 30 places this course fills up very quickly please apply and sort out your
payment method early. Places will not be confirmed until payment and a booking form
has been received. Methods of payment are by cheque made payable to Birmingham
Children’s Hospital NHS FT / BCH NHS FT If your trust is funding your place then please
apply early and contact the KIDS office when you apply. This study day is intended for all health
professionals within the multidisciplinary team who are involved in the stabilisation and care of
the critically ill child.
Birmingham Children’s Hospital
Steelhouse Lane
B4 6NH
0121 333 9687