WEMSI-International

WP Booking Page

Thank you for requesting to book the Wilderness Physician (WP) course in Scotland.

Please fill in the following Pen Picture so that we can confirm suitability for your course. This will be forwarded to our vetting Doctor who will contact you for further information if necessary.

You are required to pay a deposit as below, this is normally a PayPal transaction. If you do not have a PayPal we can give you the option of electronically transferring the deposit within 72 hours. Selecting that option will forward you the bank details.

WP Booking Form

Name*
First Last
Gender
- Male
- Female
Billing Address
Street Address Address Line 2 City County / State / Region ZIP / Postal Code Country
Contact Address
Same as previous

Street Address Address Line 2 City County / State / Region ZIP / Postal Code Country
Email*
Phone
Medical Knowledge/Previous Courses/Prior Training
Outdoor Experience / Foreign Trips*
Charity Discount
Please insert details of Charity you are involved with and reason for applying for discout. Include the Charities Number.
Dietary Requirements/ Special Requests
Professional Registration Number

Please enter your Medical Council number here.
Professional Body

Please list which professional body you are registered with (eg GMC, IMC, etc.)
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