GM Cancer Sign Up Form
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1.
Email Address
2.
First Name
3.
Surname
4.
Place of Work
5.
Work Postcode
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6.
Region
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Bolton
Bury
East Cheshire
Manchester
Oldham
Rochdale
Salford
Stockport
Tameside
Trafford
Wigan
Other (please specify)
7.
Job Title
8.
If you work in healthcare please choose the profession most suitable to you. If not, please specify in the 'other' field.
Allied Health Professional
Doctor
Healthcare Assistant
Industry Representative
Lecturer/Academic
Management/Administrative
Nurse
Pharmacist
Psychological Therapist
Public Health
Research
Surgeon
N/A
Other (please specify)
9.
For service users, please tick below
I am a person affected by cancer
10.
Interest Areas
Acute Oncology
Brain/Central Nervous System
Breast
Care Homes
Childrens
Colorectal
Communication Skills
Genomics
Gynaecology
Haematology
Head and Neck
Hospices
HPB
Living With and Beyond Cancer
Lung
Lymphoedema
Oesophago-Gastric
Supportive and Palliative Care
Primary Care
Psychological Support and Mental Health
Prehab and ERAS+
Sarcoma
Skin
Systemic Anti-Cancer Therapies
Teenage and Young Adults
Urology
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11.
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