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Username

Password

Email address

Email (again)

First name

Last name

City/town

Country

Practice/Business Name

Role in the Practice/Business

Cell Number

Title (e.g. Dr/Mrs/Mr)

Your Council

Your Council Registration Number (Prefix & Number) (Please provide your council registration number in full, - do not leave out any zeros. This will help allocate your CEUs promptly and to the correct practitioner.)

I am eligible for CEU (You will be eligible if you are registered as a practitioner with the HPCSA/other council)

Dietary Requirements

Please indicate your T-shirt size

How did you learn about this platform?

I am a GoodX Software Client

I am interested to find out more about GoodX Software

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Administrative Information

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