Coaching Clinic Booking - SJH

If you are interested in booking a coaching clinic with one of our Quality Improvement team members at St John’s, please complete the below form and one of our team will be in touch with you shortly.

Name

First Name

Last Name

Ward/Department:

Is this your first coaching clinic for this project?

Yes

If this is a follow on meeting please supply the name of your previous coach:

Please provide email addresses of any other team members you would also like to attend the session:

Project detail:

Please supply a brief overview of your proposed project, including if you have attended any Quality Improvement workshops, such as Essentials of QI.

Please list times/days you are available for a coaching session:

Consent

I consent to the QI Team contacting me in relation to QI Coaching.

How did you hear about our Coaching Clinics?