Registration form: round table discussion on medication assisted recovery

Please use this registration form (see below) if you wish to attend the round table discussion on medication assisted recovery, 3rd August, 2011.

You can use an assumed name to register for and attend this event. Stephen cannot guarantee travel expenses will be available if you use an assumed name, although he will try his hardest!

In addition, you can specify how you wish to be identified during the discussion itself; for example, on your name badge.

You will be asked if you are prescribed medicine for the treatment of addiction, as this event is primarily for those people.

If you are not prescribed medicine for the treatment of addiction you must provide a reason why you think you should be permitted to take part in the discussion. This will determine if your registration can be accepted.

Any information you provide will not be available to any other individual or organisation other than Stephen Bamber, the organiser of this event.

Thank for your interest in this discussion. I look forward to meeting you on the 3rd of August.

Warm regards,

Stephen