FAL :: First Assistants Ltd specialises in the recruitment of first assistants and surgical practitioners to work on a temporary basis in the medical sector throughout the UK

Client Booking Form
(please see our Terms and Conditions before submitting)

Client No: (existing clients)
ALL FIELDS BELOW MUST BE COMPLETED BEFORE SUBMISSION TO FAL
*Name of staff making booking:
*Position/Occupation:
*Hospital/NHS Trust:
*Email Address:
Address:
*Tel No.
Mobile No
Fax No.
Client Ref:
Date of Operation/Procedure:
Start Time of Operation/Procedure :
Surgeon's Name:
Detail of Operation/Procedure etc :
Assistant's Role:	First Assistant Surgical Assistant
Theatre/Department :
Expected Duration:
State Client Level Code – Normal Working Hours:
State Client Level Code – Out of Hours:
* Please indicate as appropriate To email this booking complete the details as appropriate and click send On submission of this form to FAL the Client agrees to FAL’s Terms and Conditions and is legally bound subject to confirmation by FAL; OR To fax a booking click [print pdf ] and complete the details as appropriate and send to: 01494 868278. On transmission of this form to FAL the Client agrees to FAL’s Terms and Conditions and is legally bound subject to confirmation by FAL; OR To post a booking click [print pdf ] and complete the details as appropriate and send to: First Assistants Ltd, Fairway House, 64-68 High Street, Great Missenden, Bucks HP16 0AN. On sending this form to FAL the Client agrees to FAL’s Terms and Conditions and is legally bound subject to confirmation by FAL; OR To telephone a booking please call 0844 800 0117. On making a telephone booking the Client agrees to FAL’s Terms and Conditions and is legally bound subject to confirmation by FAL. IMPORTANT: All methods of bookings are subject to FAL sending its written confirmation to the Client. Until FAL sends its confirmation to the Client the Client may revoke this booking by notifying FAL .

To email: click send

To fax click [print] and send to: 01494 868278