Pairing Seniors

Pairing Seniors

Please complete the form below to register as a Senior in the ICCH Pairing Programme.  (EACH members have the option of saving the form as a draft, but this must be submitted to confirm your participation.  You will see a confirmation message onscreen when you have successfully submitted the form.  EACH members may edit their profile at any time.)

 

* All fields are required.

Pairing - Senior
We will use this email address to liaise with you regarding the pairing programme.
Primary area *
Tick all as appropriate

Teacher/Training

NB: Undergraduate (Students etc), Postgraduate (Residents, trainees, etc), Continuous Professional Development (Practicing clinicians, teachers). Select multiple options as required by holding down Ctrl (PC) / Cmd (Mac).
Select multiple options as required by holding down Ctrl (PC) / Cmd (Mac).

Research

Select multiple options as required by holding down Ctrl (PC) / Cmd (Mac).
Select multiple options as required by holding down Ctrl (PC) / Cmd (Mac).

Policy/practice

Select multiple options as required by holding down Ctrl (PC) / Cmd (Mac).
Select multiple options as required by holding down Ctrl (PC) / Cmd (Mac).

Keywords describing expertise/interest

Please enter one keyword per field up to a maximum of two keywords

Description

Maximum file size: 1MB

Please note file type must be a PDF