Equal Opportunities Monitoring Ageing Face Hosted jointly with the BDA Hospitals Group

In line with UK legislation and good practice guidelines, we are asking everyone to complete this section. You are not obliged to provide any of the information in this section, but if you do so, it will enable us to monitor our business processes and ensure that we provide equality of opportunity to all. Name: .............................................................. Gender............................................................ Nationality:................................................. 1st language: ............................................... Do you have a disability under the terms of the Disability Discrimination Act 1995 (a person with a physical or mental impairment that affects your ability to carry out normal day to day activities which are substantial, adverse and long term)? Yes No ethnicity Choose one selection from the list below to indicate your cultural background: a) white:

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by bus: There are many buses that run along the Strand and Fleet Street to the Aldwych, or along High Holborn to Kingsway. by underground: The nearest tube station is Holborn on the Piccadilly and Central lines. It is a ten minute walk from Temple tube station on the Circle and District lines. Disabled access: Portable ramps and a cloakroom downstairs. Please telephone for further information. For further information please contact: Education Department Faculty of Dental Surgery The Royal College of Surgeons of England 35 43 Lincolns Inn Fields, London WC2A 3PE t (020) 7869 6810 f (020) 7869 6816 e fds@rcseng.ac.uk www.rcseng.ac.uk/fds The Royal College of Surgeons of England 35 43 Lincolns Inn Fields, London WC2A 3PE
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what is your sexual orientation? Bisexual Lesbian or Gay what is your religion or belief? Buddhist Hindu Muslim Christian Jewish Sikh Heterosexual

Any other Black background e) chinese or other ethnic group: Chinese Any other background Indicate a more specific category here:................................................................... .............................................................................. ..............................................................................

The Ageing Face Hosted jointly with the BDA Hospitals Group Thursday 24 November 2011

(020) 7869 6815 (020) 7869 6816 fdseducation@rcseng.ac.uk

www.rcseng.ac.uk/fds
Registered Charity No. 212808

Other religion/belief Indicate a more specific category here:................................................................... ..............................................................................

This information will be recorded electronically with your other data in accordance with the Data Protection Act 1998, but used only for monitoring our business practice. Nb: Applications on photocopies will be accepted

The Ageing Face Hosted jointly with the BDA Hospitals Group

Application form The Ageing Face Thursday 24 November 2011

08.45 09.20 09.20 09.25 registration welcome Miss Kathryn Harley Dean, Faculty of Dental Surgery introduction Professor Mark McGurk Course Convenor Anatomy and physiology of facial ageing Dr Caroline Wilkinson University of Dundee Anatomy and physiology of dental ageing Mr Martin Kelleher Kings College London Discussion coffee Techniques to combat dental ageing: methods of mitigating the effects of age within the oral cavity Mr Martin Kelleher Kings College London Mr Nicholas Lewis Eastman Dental Hospital blockers, fillers and peels Mr Richard Barlow Guys and St Thomas NHS Foundation Trust jaw definition in the senior citizen Mr Tim Mellor Queen Alexandra Hospital, Portsmouth Panel discussion Mr Tim Mellor Queen Alexandra Hospital, Portsmouth 13.15 14.00 14.00 14.30 lunch soft tissue lifts for seniors and fronto-orbital issues Mr Naresh Joshi Chelsea and Westminster Hospital Face and neck Mr Niall Kirkpatrick Chelsea and Westminster Hospital Panel discussion Tea rhinoplasty, perio-orbital tissues Mr David Roberts Guys and St Thomas NHS Foundation Trust legal aspects of aesthetic surgery Mr Stephen Henderson Dental Protection Ltd Panel discussion and close Please tick at the appropriate space & complete the form below. 130 110 90
Non-members FDS & FGDP Members of RCS Eng.; Diplomates in Special Care Dentistry; Members of BSDH, BSPD, BOS, BASCD & BDA Hospitals/CDS Group Trainees including postgraduate students and DCPs

Professor mark mcGurk Course Convenor The median age of the population is slowly increasing and with it comes new challenges to the medical profession. One of these is the management of the ageing face. Different surgical specialities have approached the problem from their own perspective and there is considerable overlap in treatment between specialties. The primary objective of this study is to enlighten each surgical speciality of the approach adopted by its sister specialty so that a more informed opinion can be developed for the optimum way forward in relation to various problems of facial aesthetics. In addition the medico-legal ramifications of such surgery will also be highlighted. This study day will be of interest to clinicians (doctors and dentists) who manage the ageing face. Application forms and entry requirements can be obtained from the Education Department at the Faculty of Dentistry fdseducation@rcseng.ac.uk learning outcomes At the end of the study day participants will: Understand the ageing process in the face and mouth Be aware of the approach and techniques used by different specialties Be informed of techniques that may be complementary Understand the medico-legal ramification of treatment

09.25 09.30

14.30 15.00

I wish to attend the study day on Thursday 24 November 2011 Cheque for ...........................made payable to: The Royal College of Surgeons of England Please Debit my card for ................................... credit card details Mastercard Visa Switch Delta

09.30 09.55

15.00 15.15 15.15 15.45 15.45 - 16.05

09.55 10.20

My Credit Card Number is: Expiry Date Issue No. Start Date Security No.

10.20 10.30 10.30 11.00 11.00 12.00

16.05 16.45

Cardholders name:....................................................................................................................... Signature ............................................................................. Date................................................... contact details Last name in full: ............................................................. Title .................................................... Other names ................................................................................................................................... Gender:...............................................[Male/female] DOB: ................................................. Address:.............................................................................................................................................. ................................................................................................................................................................. .................................................................................................. Post code: ....................................... Telephone day ................................................................. GDC no .......................................... E-mail:................................................................................................................................................... Mobile ................................................................................................................................................. Please indicate any dietary restrictions ............................................................................ ................................................................................................................................................................. ..................................................................................................

16.45 17.00

12.00 12.30

5 cPD credits will be awarded for this study day. Please return completed application forms to FDS Education by 23 September 2011. Please note that there is a fixed cancellation charge of 10%. cancellations made 2 weeks prior to the course will result in no refund.

12.30 13.00

Promoting Excellence in the Dental Specialties

13.00 13.15

The information you provide will be held on a College wide database and maybe shared with any relevant Specialist Associations located within the building and also the BDA Hospitals Group. It will be used for relevant College mailings and used to process your application and stored in accordance with the Data Protection Act 1998.

We would like to keep you informed of other events and activities that may be of interest to you, please tick this box if you do not wish to receive these mailings. While we make every effort to run courses as advertised, we reserve the right to change the timetable and/or the teaching staff without prior notice and to cancel any courses without liability [in such circumstance, delegates will qualify for a full refund of the course fees].