Number of Trainers Group meetings attended: Are there any other Educational roles you undertake (PCME, course tutor, Undergrad tutor etc.) Practice Details Practice Name (for database): Practice ID Number (eg Pxxxxx): Surgery Phone number: Surgery Address Practice Manager or Education Manager: Telephone: E-mail address: Details of Educators in the practice: Educator Name of Supervisor Status Status (Undergraduate, FY2 or (GP, GP Trainer) Manager, ST4/5)
Number of Trainers Group meetings attended: Are there any other Educational roles you undertake (PCME, course tutor, Undergrad tutor etc.) Practice Details Practice Name (for database): Practice ID Number (eg Pxxxxx): Surgery Phone number: Surgery Address Practice Manager or Education Manager: Telephone: E-mail address: Details of Educators in the practice: Educator Status (GP, Manager, ST4/5) Name of Supervisor Status (Undergraduate, FY2 or GP Trainer)
Trainer%20First%20Review%20Form.docx