Endometriosis Information Day

Saturday 19th October 2013 Windmill Village Hotel, Coventry

We are delighted to be holding our next Patient Information Day on Saturday 19 th October 2013, at the Windmill Village Hotel, Birmingham Road, Allersley, Coventry. It is open to anyone who would like to know more about endometriosis, including women who have the disease, their partners, family and friends and healthcare professionals. The Information Day will run from 9.30am until 4.00pm. Refreshments and lunch will be provided. The hotel can be reached easily by car (just off the A45) or by train with both Birmingham International and Coventry stations close by. The day will consist of seminars from leading consultants and health practitioners covering surgical options, hormonal treatments and pain management, followed by a choice of afternoon workshops including fertility, endometriosis posthysterectomy/menopause and supporting someone with endometriosis. There will also be opportunities for you to put your questions to medical experts and share your experiences with others. Other stalls and information sharing opportunities are planned. Please note seminars and workshops may change at short notice. Places are limited and will be secured in order of receipt of booking form and payment. Ticket Information Ticket Price: Early booking discount: 32.00 per person 26.00 (for bookings received by 31st August 2013)

Please complete the booking form and return with your payment using any one of the following methods: Email: Post: admin@endometriosis-uk.org Endometriosis UK Suites 1 & 2 46 Manchester Street London W1U 7LS

Please note: We are unable to accept bookings over the telephone. Once your booking form is received, you will receive confirmation and asked to provide us with details of any dietary needs. Afternoon workshop choices can be made on the day. The confirmed itinerary for the day will then be sent to you with your ticket and venue information two weeks prior to the event.

Endometriosis Information Day - Saturday 19th October 2013

9.30am 4pm

BOOKING FORM

Name Address inc postcode

Email Contact telephone number We are looking into the possibility of having a taxi/bus shuttle service from both Birmingham International and Coventry train stations. Tick this box if you would be interested in sharing this service. There may be a small charge payable at the time I would like to purchase _______ tickets at 26 (early booking by 31 st August) I would like to purchase _______ tickets at 32 (for bookings after 1 st Sept) I enclose my cheque for _______ Please make cheques payable to Endometriosis UK I made a bank transfer to Endometriosis UK Sort code: 40-52-40 Account number: 00005509 of _______ Please use reference number 0613 followed by your surname Please charge my debit/credit card the amount of ________ Name (as it appears on your card) _______________________________ Card Type Visa Mastercard American Express JCB Visa Delta Solo Card No _ _ _ _ /_ _ _ _ /_ _ _ _ /_ _ _ _ Issue No (Maestro cards) _ _ Expiry_ _ /_ _ / _ _ Start Date (if applicable) _ _ / _ _ / _ _ Security _ _ _ Signature Date __________________________________ __________________________________

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