Application forms for the 'Best Care Scholarship' must be sent to:

Susan Madge, Department of Cystic Fibrosis, Royal Brompton Hospital, Sydney Street, London SW3 6NP, UK.  email: S.Madge@rbh.nthames.nhs.uk

You may also downolad the application form in .pdf format and send it to the above address.

Click to
download the form

Name

Place of Work

Full postal address

Fax number

Phone number

email address

Current clinical position

Number of hours per week treating patients with

Length of time in CF clinical position

Name of the CF centre you wish to visit for your exchange

Reasons for your choice of specialist area (Please include a literature review)

What do you hope to achieve by visiting this centre?  (please list learning objectives)

How will this experience benefit your patient group/colleagues ?

How do you plan to disseminate your knowledge to your patients, colleagues and the wider CF nursing community?

Please include a full curriculum vitae to support this application.
Application can only be made if leave has been agreed by your line manager. Copy of this agreement must be enclosed