‌

TTDL Course Registration Form

Page 1

*
Question 1.

Your Name and Surname

- Required.
*
Question 2.

Professional Registration Number:

- Required.
*
Question 3.

Date of registration with your local medical council

- Required.
*
Question 4.

Qualifications

- Required.
*
Question 5.

Name of Medical School, Country

- Required.
*
Question 6.

Address

- Required.
*
Question 7.

Mobile no:

- Required.
*
Question 8.

Whatsapp no:

- Required.
*
Question 9.

Email address:

- Required.
*
Question 10.

Which sessions would you like to register for? Please note you will be requested to pay for the event in full at least 4 weeks in advance.

- Required.
*
Question 11.

I confirm to pay the full amount of fee as required by The Talking Doctor Ltd. before my first session. I also understand that no session will be commenced without full payment. I will receive an invoice to submit for reimbursement from my department, should I require. 

- Required.
*
Question 12.

Photography Consent
Photos and/or videos taken at the face-to-face or online teaching sessions and associated events may be published in print or posted online for download, in online photo albums, on photo/video sharing sites such as YouTube and/or on social media sites such as Facebook, LinkedIn, X (Previously Twitter), Whatsapp etc. Photos and videos may be made available through email on request. By your attendance at the teaching session/s, you are consenting to your photographs and feedback being taken and shared through the above-listed platform(s), unless you expressly revoke your consent in this matter.

- Required.