Clinical First Approval: Reapproval 1 2 Supervisor One Training Year (4 years) Approval: Conditions Withdrawal of 3 4 (See Appendix A) (6m-1 year) Approval Patch Associate Dean Name: Date: Report Approved by GP-STC Dr Richard Weaver Director of Primary Care Education & Head of GP School, Health Education Wessex Date: ADMIN SECTION to be completed by Patch Office* and Wessex GP School **: *Clinical Supervisor *E&D Date & Certificate **Date Intrepid **Date approval **Date QA **Date SLA provided? updated? email sent informed received Course Attendance Date & Certificate provided? Section One: Applicant’s Details, continued
Clinical Supervisor Approval: (See Appendix A) 1 First Approval: One Training Year 2 Reapproval (4 years) 3 Conditions (6m-1 year) 4 Withdrawal of Approval Patch Associate Dean Name: Date: Report Approved by GP-STC Dr Richard Weaver Director of Primary Care Education & Head of GP School, Health Education Wessex Date: ADMIN SECTION to be completed by Patch Office* and Wessex GP School **: *Clinical Supervisor Course Attendance Date & Certificate provided? *E&D Date & Certificate provided? **Date Intrepid updated? **Date approval email sent **Date QA informed **Date SLA received Section One: Applicant’s Details, continued
Approval_Reapproval_Visit%20Report_I&R%20supervisor_2016.docx