Military Locum Registration Form

If you would like to apply to join our team of Military Locum doctors, please complete the registration form below.

For your application you'll need to download and complete the following documents (in Word format):

Please either edit the documents directly and save them for upload later or print them out, fill them in and scan them ready to upload or post them to us.

You'll also need to provide the following documents either as scanned documents uploaded or as photocopies by post

  • Up-to-date CV with names, addresses and telephone numbers of at least two referees (one of which must be from most recent post).
  • A copy of current GMC registration
  • A copy of current Medical Indemnity Insurance certificate
  • A copy of JCPTG/PMETB or equivalent / acquired rights certificate
  • GMC GP register inclusion (if available)
  • A copy of proof of inclusion on a Primary Care Performers List (formerly HA Supplementary List)
  • Copies of any postgraduate qualifications
  • Proof of Hepatitis B immunity
  • A copy of passport showing that you are a British citizen, or have the right of abode in the UK
  • Copy of an in-date utility bill, showing current address
  • A recent copy of your CRB Enhanced Disclosure
  • Completed registration documents

Personal Details

   

Emergency Contact Details

Qualifications

Medical Idemnity

I confirm that the information given on this form is correct and complete, and that any misleading statements may lead to the cancellation of any greements made.