Conquering COVID application form

Participant Details

Programme dates

Please state the cohort you wish to join (number 1, 2 or 3), in order of preference. Please note: whilst every effort will be made to accommodate your first choice of dates, this cannot be guaranteed. A full list of dates can be found at the top of this page.

Requirements of participation

To realise the full benefits of the programme, and to receive your certificate of participation, participants will need to commit to attending and taking part in all ten Long COVID Recovery Programme sessions within your assigned cohort, and to complete pre, mid-point and post programme surveys.

Declaration

Equal opportunities

The RCN believes strongly in equal opportunities. In order to ensure that our services are meeting the needs of all delegates, we would be grateful if you could complete the following information. This information will be treated in the strictest confidence and will only be used to evaluate trends.

Disability

The Equality Act (2010) defines a disabled person as someone with a ‘physical or mental impairment which has a substantial and long-term adverse effect on his/her ability to carry out normal day-to-day activities.

By submitting this form, you are giving the RCN permission to contact you about the programme.

You can control the information you receive from the RCN by updating your preferences at MyRCN.

The information you provide in this form will be stored by the RCN.

Protecting your privacy is very important to us. Please view our privacy policy to find out more about the information we collect and how it is used.