If you are having difficulties submitting the form below, please consider the following:
  • Some of the boxes only accept whole, numerical values, such as "3" or "200".  If you enter letters alone in some boxes such as "three" or "two hundred" they may disappear after you enter them.  If you enter words and numbers such as "8 months" or "25 hours CPD", the form may accept these entries but you will not be able to submit it at the end.  The same will occur if you enter decimal fractions such as "1.5".  Please ensure you use whole numerical values, where such responses are relevant e.g. number of patients / hours / years.
  • Your Flash player may require updating, in order to complete and submit this form.
  • Some NHS systems may not allow links to PayPal or the firewall may cause problems.  You may wish to complete the form from a home computer if you are having difficulties at work.
If you are still unable to submit the form, please contact the secretary, who will endeavour to find a solution.