Falls Prevention + Quality Improvement for RACHs

Name of Residential Aged Care Facility *

Name *

Position / Role *

Email address *

Mobile Number *

Which training session would you like to attend? (Please select one) *

Orange, Tuesday 22 September, 9:00am-12:00pm, The HiveOrange, Tuesday 22 September, 2:00pm-5:00pm, The HiveDubbo, Wednesday 23 September, 2:00pm-5:00pm, The Western Plains Cultural CentreDubbo, Thursday 24 September, 9:00am-12:00pm, The Western Plains Cultural Centre

Do you have any dietary requirements? *

YesNo

If Yes, list dietary requirements *

I agree for my information being used by the Western NSW Primary Health Network (WNSW PHN), as the event organiser, to communicate with me via relevant registration and distribution lists regarding this event and other services.
*

For more information please contact agedcare@wnswphn.org.au.