Graduate Certificate in Obstetrics and Gynaecology
Graduate Certificate in Obstetric and Gynaecological Ultrasound
Module 2 Fetal Biometry, Liquor, Placenta
Declaration of Clinical Placement
Applicant’s Name:
_________________________________________
Hospital Name & Address:
__________________________________________
__________________________________________
__________________________________________
__________________________________________
__________________________________________
__________________________________________
Name of Clinical Supervisor:
__________________________________________
I confirm that the above applicant is guaranteed to obtain a minimum of 100 hours clinical experience whilst undertaking the Module 2 of the Graduate Certificate in Obstetrics and Gynaecological Ultrasound Programme.
Applicant’s Signature:______________________________ Date:________
Clinical Supervisor Signature:__________________________ Date:________
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