ࡱ> *,) bjbj)) :@rCAgrCAg ( ( Tl7V<Nk$E!#"<v<2@D0  07,$d$2$2p{d7$( H:  Application for Paediatric Carers of Children Feedback - PaedCCF Tool Please note all fields must be completed. Please e-mail this form to:  HYPERLINK "mailto:revalidation@rcpch.ac.uk" revalidation@rcpch.ac.uk PARTICIPANT DETAILS Note: This tool is suitable only for doctors in non-training posts. Name: GMC Number: Email: Phone: Name of organisation: Please select the PaedCCF type you wish to use:Outpatients:  CONTROL Forms.CheckBox.1 \s  ICU:  CONTROL Forms.CheckBox.1 \s Area of Paediatric Subspecialty: (if applicable) How did you hear about PaedCCF?PAYMENT To make payment for your application for the PaedCCF Tool, please follow the instructions below. (Please note that if you are already logged into the RCPCH website, you can go directly to  HYPERLINK "/account/paedccf/subscribe" /account/paedccf/subscribe and follow the onscreen instructions to make payment) Visit the RCPCH website (HYPERLINK "http://www.rcpch.ac.uk/"www.rcpch.ac.uk) and log in using your RCPCH number and password. If you do not have an RCPCH number and login, you are able to register by visiting HYPERLINK "/user/signup"/user/signup. You are also able to reset your login details via this link. Select My Account in the top-right hand corner of the page On the My Account page, you will find a section titled PaedCCF. Please click Subscribe to PaedCCF. From the next page, you can select the type of PaedCCF round for which you would like to apply (Outpatient or ICU) and follow the onscreen instructions to make payment. Should you require any assistance, please contact the Team by email: HYPERLINK "mailto:revalidation@rcpch.ac.uk"revalidation@rcpch.ac.uk  Signed:  CONTROL Forms.CheckBox.1 \s By crossing this box I, the PaedCCF participant, hereby sign it electronically.  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