Thank you for agreeing to be a speaker at The Primary Care Show 2024. To get the conference programme live on the website and promote your involvement in the event, we’d be grateful if you could complete this form. Please note it is important to accurately complete all information to allow attendees to claim CPD certification for attending your session. * Speaker Title (i.e. Dr, Professor, Mr, Mrs etc) * Speaker First Name * Speaker Last Name * Speaker Job Title * Speaker Organisation * Speaker Mobile NumberThis will not be published, this is for onsite emergency use only. * EmailThis will not be published, but will be used to register your badge. Re-enter to verify: Email Secondary Contact Email Address (i.e. secretary, session sponsor liaison) Please detail any expenses you will require for participating.If you are speaking on behalf of a sponsor or exhibitor, they should cover your costs. If we confirm your session and you need to cancel, we cannot cover any expenses. Once we notify you of your session time if you feel you need hotel accommodation, we will organise this on your behalf - accommodation is dependent upon the timing of your session and journey and not provided automatically. Please detail any specific requirements/adjustments you require to assist you in the delivery of your presentation: * Speaker Biography (150 words max) Please Upload Your Speaker Headshot As Png Or Jpeg Please Ensure This Is At Least 300dpi. * Select Files File uploading Click 'Upload' button to change image. Upload Crop Image Width: Height: Lock proportions: Resize Image Your headshot will be used on your speaker profile, within the Event Guide and on marketing materials. Please ensure this is a high-quality, clear image of yourself with no one else in the image. * Session title * Short description of content and learning outcomes for delegates. Twitter Linkedin Facebook * Would you be happy to record a short 20-30 second video, talking about your session and why The Primary Care Show is a must-attend event for social media promotion? - Select -YES NO * Who is the session aimed at? Please select all that applyDoctor/ GP/ GP PartnerNurses/ Nurse Practitioner/ Community NursePractice Manager/ Management/ Business ManagerPCN – Primary Care NetworkFCP – First Contact PractitionerICB – Integrated Care BoardAHP – Allied Health ProfessionalARRS - Additional Roles Reimbursement SchemePharmacistParamedicMidwiferyHealth VisitorAcademicStudentThis field is required. * Please select the product and service categories that apply to your session. Please select all that apply:Cardiovascular HealthChild and Baby CareDermatologyDiabetes and ObesityDigital Healthcare / IT Software & SolutionsHealth Education, Promotion and TrainingHealthcare Equipment and DevicesHealthy LifestyleInfection PreventionMedication, Prescriptions, Pharmaceuticals and OTCMedicines Management / Medicines optimisation programmesMental HealthMinor Surgery SuppliesNutrition and DieteticsPain ManagementPatient Information and SupportPhysiotherapy and RehabilitationPodiatry and OrthoticsPractice/Business Management ServicesRecruitmentRespiratory HealthVaccinationsWomen’s HealthWound CareThis field is required. * Do you give MA Exhibitions permission to video record your presentation and make it available to attendees after the event?- Select -YES NO * Do you give MA Exhibitions permission to make a copy of your presentation available to attendees after the event? - Select -YES NO * Would you like to be interviewed by members of the Press? Please note by selecting YES you are consenting to us sharing your contact details with members of the Press.- Select -YES NO I have read & understood the privacy policyThis field is required. Please read our privacy policy. This will explain how we process, use & safeguard your data. In addition to this service, Primary Care Show 2024, other parts of the Mark Allen Group and partner organisations would like to contact you about events, products & services that we think will be of interest to you. If you would like to update your marketing preferences, please click here. CAPTCHA As an anti-spam measure, please type the characters you see in the image (case sensitive). Submit
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