Registration Form
*Please fill in this form to register your interest in attending the 2nd Leicester Interventional Pain Cadaver Workshop due to take place at the University of Leicester on 2-3 July 2019 and the Major Joints and Spine Denervation Workshop on 4 July 2019. For further information, contact: ciaranwazir@gmail.com
Title *
Prof, Dr, Mr, Miss, etc
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Surname *
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First Name *
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Medical Speciality (incl. Pain Medicine, Anaesthesia, Neurology, Neurosurgery, etc) *
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Institution/Correspondence Address *
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E-mail Address *
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Contact No
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Please let us know whether you would like to attend the 2nd Leicester Interventional Cadaver Workshop on 2-3 July 2019 *
Please let us know whether you would like to attend the Major Joints & Spine Denervation Workshop on 4 July 2019 *
Please use the space below for any message you have for the organisers:
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