Application Form For One Day Course-of-5 on Saturday 21st January 2012,

Saturday 21st January 2012, at Raymede Clinic, St Charles Hospital, Exmoor Street, London W10 6DZ

To attend the course you must have:
1. Registered for an e-learning portfolio
http://www.e-lfh.org.uk/index.html

2. Successfully completed Electronic Sexual & Reproductive Healthcare learning package
http://www.e-lfh.org.uk/projects/e-srh/index.html
forwarding evidence to this office no later than two weeks prior to the Course of 5

3. Sent cheque for sum of £300.00 made payable to ‘NWLH General Charitable Fund’ to:- Alison Little, Westside Contraceptive Services, Raymede Clinic, St Charles Hospital,
 Exmoor St, London. W10 6 DZ

Registration fee represents 1 day Course and all refreshments

PLEASE NOTE
1. A place on the course can only be secured by cheque payment for the full amount.
2. The whole fee will be forfeited if you do not
a) send evidence to this office no later than two weeks prior to the Course of 5, or
b) attend the course.

The DFSRH requires basic gynaecological skills as an entry requirement; therefore GP Registrars should commence their O&G rotation prior to the Course of 5. If you do not intend to take a training post in gynaecology you will need to arrange to obtain some post graduate practical experience before taking the diploma, and for an appropriate educational supervisor to sign the pre course form. This may be from a Consultant in gynaecology or GUM, or a GP who has gynaecological experience. It may be helpful to undertake local training to obtain recognition as a smear taker, as this will ensure that you can use a speculum, and there will be opportunities to perform a pelvic examination which will stand you in good stead for the skills you will need to develop for the DFSRH.

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