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| Given name | Family name |
| Email address |
| Career choice | Yes | No | |
| I have decided I want to be a GP | |||
| I have decided I do not want to be a GP | |||
| I have decided I want to be a specialist | |||
| If yes, please state the specialty you have chosen | |||
| I have decided against a specialty | |||
| If yes, please state the specialty you have decided against | |||
| I have made no firm decisions about my career | |||
Please email to XX@XX.ac.uk within 1 week.
