FICE - Focused Intensive Care Echocardiography

Cardiff Focused Intensive Care Echocardiography (FICE) Course - 13th June 2017 Or 10th October 2017

Course Application Form
RUN BY: The Department of Anaesthetics and Cardiology, Intensive Care and Pain Medicine, 3rd Floor B Block, University Hospital of Wales, Cardiff, CF14 4XN
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Special Dietary Requirements

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PAYMENT BY CHEQUE

Please make cheques payable to 'Cardiff University':

For the attention of Catherine Hough
Department of Anaesthetics, Intensive Care and Pain Medicine
3rd Floor 'B Block Main Building, University Hospital of Wales
Heath Park, Cardiff, CF14 4XW

Email: houghc@cardiff.ac.uk

PAYMENT BY BANK TRANSFER

If you would like to pay by bank transfer please make sure you have ticked the box above and details will be sent to you.

If sending a cheque please print this form or add a note (so that we know which course you are paying for) and send with your payment to the address above.
Course Fee: £150.00
Please make cheques payable to 'Cardiff University':

For the attention of Mrs Maria Gundy
Department of Anaesthetics, Intensive Care and Pain Medicine
3rd Floor 'B Block Main Building, University Hospital of Wales
Heath Park, Cardiff, CF14 4XW

Email: houghC@cardiff.ac.uk

To enable us to confirm your place please print this form and send with your payment to the address above
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Cardiff Focused Intensive Care Echocardiography (FICE) Course - 13th June 2017 Or 10th October 2017