Heart Research UK Leeds Exercise Prescription in Congenital Heart Disease Masterclass - Heart Research UK

Heart Research UK Leeds Exercise Prescription in Congenital Heart Disease Masterclass

To be considered for a place on our Masterclass in Exercise Prescription in Congenital Heart Disease on Thursday 7th and Friday 8th November 2019, please fill in all of the fields below.

Title *
MrMrsMsMissDrProfessor

First name *

Last name *

Place of work *

Email *

Mobile Number *

Job title *

Reason for attending / what do you expect to gain? *

Do you currently prescribe exercise to your congenital heart disease patients? *
YesNo

If no, please give a reason below. *

How did you hear about the Masterclass? *

Name Badge details eg. Name and Institution *

Will you require overnight accommodation? *
YesNo

Will you be attending the Masterclass dinner? *
YesNo

If yes, please note any dietary requirements below *

Marketing

We’ll use your details to fulfill your request and your information will be added to our database. Please tick the relevant box below to say how you would prefer to be contacted (you can tick more than one box).

We promise to always keep your details safe. Occasionally, we would like to send you information about what we do and how you can support us. You are in control and if you later decide you no longer want to hear form us, you can update your records by visiting: www.heartresearch.org.uk/preference, emailing info@heartresearch.org.uk or calling 0113 234 7474.

View our privacy policy at: www.heartresearch.org.uk/privacy *
PostEmailPhoneText