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Name* First name Surname Phone NumberEmail* Enter Email Confirm Email Post Code* ZIP / Postal Code Country*AfghanistanÅland IslandsAlbaniaAlgeriaAmerican SamoaAndorraAngolaAnguillaAntarcticaAntigua and BarbudaArgentinaArmeniaArubaAustraliaAustriaAzerbaijanBahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBermudaBhutanBoliviaBonaire, Sint Eustatius and SabaBosnia and HerzegovinaBotswanaBouvet IslandBrazilBritish Indian Ocean TerritoryBrunei DarrussalamBulgariaBurkina FasoBurundiCambodiaCameroonCanadaCape VerdeCayman IslandsCentral African RepublicChadChileChinaChristmas IslandCocos IslandsColombiaComorosCongo, Democratic Republic of theCongo, Republic of theCook IslandsCosta RicaCôte d'IvoireCroatiaCubaCuraçaoCyprusCzech RepublicDenmarkDjiboutiDominicaDominican RepublicEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEswatini (Swaziland)EthiopiaFalkland IslandsFaroe IslandsFijiFinlandFranceFrench GuianaFrench PolynesiaFrench Southern TerritoriesGabonGambiaGeorgiaGermanyGhanaGibraltarGreeceGreenlandGrenadaGuadeloupeGuamGuatemalaGuernseyGuineaGuinea-BissauGuyanaHaitiHeard and McDonald IslandsHoly SeeHondurasHong KongHungaryIcelandIndiaIndonesiaIranIraqIrelandIsle of ManIsraelItalyJamaicaJapanJerseyJordanKazakhstanKenyaKiribatiKuwaitKyrgyzstanLao People's Democratic RepublicLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacauMacedoniaMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMartiniqueMauritaniaMauritiusMayotteMexicoMicronesiaMoldovaMonacoMongoliaMontenegroMontserratMoroccoMozambiqueMyanmarNamibiaNauruNepalNetherlandsNew CaledoniaNew ZealandNicaraguaNigerNigeriaNiueNorfolk IslandNorth KoreaNorthern Mariana IslandsNorwayOmanPakistanPalauPalestine, State ofPanamaPapua New GuineaParaguayPeruPhilippinesPitcairnPolandPortugalPuerto RicoQatarRéunionRomaniaRussiaRwandaSaint BarthélemySaint HelenaSaint Kitts and NevisSaint LuciaSaint MartinSaint Pierre and MiquelonSaint Vincent and the GrenadinesSamoaSan MarinoSao Tome and PrincipeSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSint MaartenSlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSouth GeorgiaSouth KoreaSouth SudanSpainSri LankaSudanSurinameSvalbard and Jan Mayen IslandsSwedenSwitzerlandSyriaTaiwanTajikistanTanzaniaThailandTimor-LesteTogoTokelauTongaTrinidad and TobagoTunisiaTurkeyTurkmenistanTurks and Caicos IslandsTuvaluUgandaUkraineUnited Arab EmiratesUnited KingdomUnited StatesUruguayUS Minor Outlying IslandsUzbekistanVanuatuVenezuelaVietnamVirgin Islands, BritishVirgin Islands, U.S.Wallis and FutunaWestern SaharaYemenZambiaZimbabwePlace of work:* Job role:*-- Choose your job role --Tissue viability nurseAdvanced Nurse PractitionerAncillary nurseAssistant practitionerAuxillary nurseCare assistantCarerCase managerClerical nurseCommunity matronCommunity nurseCommunity staff nurseCommunity support workerDistrict nurseDistrict nursing sisterGeneral practitionerHealth care assistantHealth visitorHome managerIndustry representativeLecturerLeg ulcer specialistLink nurseLymphoedema nurseMidwifeNurse practitionerNurse prescriberOther qualified health professionalOther qualified nurseOther specialist nursePaediatric nursePharmacistPodiatristPractice nursePrimary care nurseRegistered general nurseStudentTeam teaderSelect the event you attended:*Please select event06/04/2021, Post Covid - what’s next for shared care in wound management?26/11/2020, Managing atypical wounds20/10/2020, Making shared management of wounds part of everyday life30/9/2020, Understanding wound pain: the physiology of nociceptors and inflammation17/9/2020, WATCH PARTY: Addressing exudate in VLU: shifting from management to reduction02/7/2020, Transforming wound care: simplifying patient pathways28/5/2020, Transforming wound care: simplifying infection management04/3/2020, Addressing exudate in VLU: shifting from management to reduction20/2/2020, Periwound skin care: getting it right24/9/2019, The exudate debate: getting it right in primary care25/6/2019, Why debride? A patient-centred approachHiddenQuestionnaire sectionPlease could you rate the relevance of the topic covered in the live event:(5 = very relevant; 1 = not at all relevant) 5 4 3 2 1 Please could you rate your overall experience of the live event:(5 = very relevant; 1 = not at all relevant) 5 4 3 2 1 Did you have any technical difficulties during the live event? Yes No Please describe the technical difficulties you had:*What platforms would you be interested in seeing future live events on: Facebook YouTube JCN Website Other If 'Other' please specify*Do you have any further comments?Would you like to hear about future events that are being run either live on Facebook or in your area from GPN?* Yes No Would you like your information shared with the sponsor of this event for them to contact you about products and services mentioned in this event?* Yes No Would you like your information shared with the sponsor of this event - HARTMANN GROUP - for them to contact you about products and services mentioned in this event?* Yes No HiddenI am happy to receive emails from the HARTMANN GROUP and be kept up to date with their products and services, news and events Yes No HiddenWould you like your information shared with HARTMANN (the sponsor of this event) for them to contact you about products and services mentioned in this event, including HOME? Yes No HiddenWould you be interested in further information from L&R about any of the topics presented today? Yes No HiddenWould you be interested in further information from H&R Healthcare about any of the topics presented today? Yes No HiddenWould you be interested in further information directly from Coloplast about any of the topics presented today? Please note that choosing 'Yes' will mean your information will be shared with Coloplast. Yes No By completing this form you agree to our privacy policy.CAPTCHAHiddenSection BreakHiddenHARTMANN Logo HiddenH&R Healthcare Logo HiddenL&R Logo HiddenColoplast Logo HiddenSection Break
