Practice Manager Development Coaching and Mentoring Support – Expression of Interest

Page 1 of 8

Closes 21 Jan 2019

Practice Manager Development Coaching & Mentoring Support – Expression of Interest

The information gathered in this section will enable us to contact you to let you know the outcome of your expression of interest.

1. What is your name?

2. What is your home address?

This will only be considered for matching you to a coach/mentor.

3. What is your work address?

4. What is the name of the General Practice that you work at?

5. What is your email address?

6. Please provide your mobile telephone number so that you can be contacted directly about the PM Coaching and Mentoring programme by your allocated Coach/Mentor:

7. Are you currently or have you recently taken part in a Practice Manager Coaching and Mentoring project via your local LMC since October 2017?

Priority may be given to Practice Managers who have not received coaching and mentoring in the last year. However, if you have, we will still consider your application so please complete.