Patient Safety Learning Conference 2019

Thanks for joining us at our conference. We need this short form to be completed for everyone who is coming.

Once you're finished, you will have the option to complete the form again for the next person in your party, if applicable.

Thank you for taking the time to do this. We appreciate it.

First Name

Last Name

If 'yes', please give us details

Accessibility requirements?NoneWheelchair accessHearing loopOther

If 'other', please give us details

Photo and video consent

We will be recording the conference on video and taking photographs throughout. We may also give some delegates opportunities to offer their thoughts on video. All such images and recordings will be used solely by Patient Safety Learning and only to inform or promote our work.

ConsentI give permission to Patient Safety Learning take photographs and / or video of me. I grant full rights to use the images resulting from the photography/video filming, and any reproductions or adaptations of the images for fundraising, publicity or other purposes to help achieve the charitable aims of Patient Safety Learning. I do not give permission to Patient Safety Learning take photographs and / or video of me.

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Patient Safety Learning would like to keep you informed about future news, events and activities. We will not sell or share your information with any other organisation. By opting in, you are consenting to emailed by us about news, events and other ways for you to stay involved with our work.

You can update your preferences directly with Patient Safety Learning at any time.

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Patient Safety Learning Conference 2019: A Blueprint for Action

Photo and video consent

Newsletter subscription

A platform for anyone with an interest in patient safety to share and learn from one another. Learn more.

Patient Safety Learning Conference 2019: A Blueprint for Action

Photo and video consent

Newsletter subscription

A platform for anyone with an interest in patient safety to share and learn from one another. Learn more.

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