1a) 1b) 1c) 1d) 1e) 1)f 1g) 1h) 1i) Professions GMC GMC/ NMC/ GMC: Name GMC/NMC: Date of last Date of last Date of last Level of UK register Specialist HPC: of Date of next appraisal? adult children’s children’s GMC/ NMC/ register Registration Designated revalidation safeguarding safeguarding safeguarding HPC or other qualification? Number Body with the training (or training (or training. professional E.g. GMC/NMC state state ‘none’). ‘none’). healthcare psychiatry. registration? Staff identifier: Staff identifier: Staff identifier: Staff Identifier: Staff Identifier: Staff Identifier:
1a) Professions UK register GMC/ NMC/ HPC or other professional healthcare registration? 1b) GMC Specialist register qualification? E.g. psychiatry. 1c) GMC/ NMC/ HPC: Registration Number 1d) GMC: Name of Designated Body 1e) GMC/NMC: Date of next revalidation with the GMC/NMC 1)f Date of last appraisal? 1g) Date of last adult safeguarding training (or state ‘none’). 1h) Date of last children’s safeguarding training (or state ‘none’). 1i) Level of children’s safeguarding training. Staff identifier: Staff identifier: Staff identifier: Staff Identifier: Staff Identifier: Staff Identifier:
Independent%20doctors%20PIR%20sample.docx