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Register of interest to assist in COVID-19 vaccinations

We are compiling a register of GPs, nurses and pharmacists who are available to work shifts in vaccination clinics. Please complete this form if you are interested.

    First name

    Surname

    Email address

    Phone number

    Profession
    General PractitionerNurse ImmuniserPharmacist Immuniser

    Do you consent to your contact details being shared with practices / respiratory clinics / vaccination hubs seeking additional staff?
    YesNo