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240 results matching “cranford hospice referral form”
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DHBNZ - Request for Reference: Resident Medical Officer Position
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This form outlines the additional information that we will require as part of an application for provisional vocational registration in psychiatry.
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This page contains a full list of our forms including application, report and referee forms, as well as checklists and the current fees payable.
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Request for certificate of registration
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NZREX Clinical - Application for new candidates
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Each year CPMEC recognises clinical educators across Australia and New Zealand who have made valuable contributions to prevocational medical education and training. PGY1 and PGY2 doctors are eligible to nominate a clinical educator for this award.
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Each year CPMEC recognises junior doctors across Australia and New Zealand who have made valuable contributions to prevocational medical education and training. Prevocational Education Supervisors, Clinical Directors of Training and CMOs are eligible to nominate a junior doctor for this award.
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This form further outlines the additional information that will be required by the ACEM so it can provide us with advice on your application for vocational registration in emergency medicine.
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Special purpose scope - application to amend practising certificate
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The purpose of this agreement is to set out the terms of reference for the collegial relationship and clarify the objectives and responsibilities of each colleague.
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if you are in a collegial relationship you should use this form to keep a record of the meetings you have with your colleague.
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If you are in a collegial relationship, you should use this form to record any optional activities you complete - that is, activities that are not specifically required.
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Application for registration in New Zealand
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Doctors on provisional general and special purpose scope: Employer application for approval of position and supervisor
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Application for restoration to the medical register
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Provisional vocational (VOC4) scope - application for approval of position and supervisor
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Referee report for use when applying for registration.
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Application for Special Purpose: Visiting Expert Registration for teaching as a Visiting Expert
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Application for vocational registration if you don't hold an approved postgraduate medical qualification from New Zealand or Australia.
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Application form for provisional vocational registration if you hold an approved postgraduate medical qualification.
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CV template when applying for VOC4
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Checklist for registration in New Zealand - locum tenens registration
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Checklist 2: United Kingdom and Irish medical graduates - Part A: Checklist for registration in New Zealand
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Special Purpose: Teleradiology - Checklist for new applicants
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Special Purpose: Teleradiology - Checklist for reapplying applicants
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Checklist 5: Practice profile form for use by doctors applying down the comparable health system pathway.
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CHKL8: United Kingdom general registrants pathway
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The Clinical Supervisors Guide outlines the role of the clinical supervisor in the prevocational medical training programme
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NZREX Clinical - Checklist of documentation that must be provided with application
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Request for confirmation of internship, NZREX pass, or general registration.
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This pamphlet explains the role of a Professional Conduct Committee (PCC) and what to expect if you are referred to a PCC.
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ES1 application form for authorisation to provide secondary maternity services
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The purpose of the CPD Associate agreement is to assist you in maintaining safe and competent practice, and to clarify your responsibilities, as well as those of the CPD associate.
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Application for registration: Australian graduates (Interns/PGY1)
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Guide to providing a complete application for registration within a vocational scope of practice.
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NZREX Clinical - Application for repeat candidates.
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The New Zealand Curriculum Framework for Prevocational Medical Training (NZCF) outlines the learning outcomes to be substantively completed in PGY1 and by the end of PGY2
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This guide is for supervisors who are creating robust training objectives for doctors applying for registration in New Zealand under the Special Purpose Post Graduate Training pathway.
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This pamphlet explains the role of a Professional Conduct Committee (PCC) and what to expect if your notification about a doctor is referred to a PCC.
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This form outlines the additional information that will be required by the ACEM so it can provide us with advice on your application for vocational registration in emergency medicine.
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This form outlines the additional information that will be required by the ACEM so it can provide us with advice on your application for vocational registration in emergency medicine.
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This form outlines the additional information that will be required by the RACP so they can provide us with advice on your application for vocational registration in dermatology.
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This form outlines the additional information that will be required by the RACP so they can provide us with advice on your application for vocational registration in paediatrics.
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This form outlines the additional information required for VOC4 applications in obstetrics & gynaecology
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Practice intentions - To be completed by doctors applying for a PC to return to work after an absence of three or more years
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Provisional general scope - application to vary practising certificate
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Provisional vocational scope - application to vary practising certificate
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Application for general scope of practice for doctors on a provisional general scope of practice (excluding Interns).
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Application for change of scope from provisional vocational to vocational (ex-provisional)
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If you are in a collegial relationship, you should use this form to record the details of any audits of your medical practice.
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If you are in a collegial relationship, you should use this form to keep a record of the CME activities you complete.
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If you are in a collegial relationship, you should use this form to keep a record of any peer review you do.
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Complete this form to confirm you are enrolled and actively participating in an approved recertification programme.
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Form to confirm that the doctor is enrolled and actively participating in Inpractice, the recertification programme for doctors registered in the General scope of practice.
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NZREX Clinical - Application to withdraw from an examination
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NZREX Clinical - Application to change to a later examination
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Declaration: Special purpose scope of practice – postgraduate training
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Application for a practising certificate for doctors registered in a provisional or special purpose locum tenens scope who are returning to medical practice in New Zealand. This form supersedes the REG9 and REG11 forms.
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Request for advice on eligibility for medical registration in New Zealand
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Employer application for approval of position and supervisor (UK & Irish graduates, comparable health system, and locum tenens pathways)
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Provisional vocational scope - application for approval of position and supervisor
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APPLICATION FORM SUPERSEDED - Please use the new REG12 form
Application for a practising certificate for an IMG registered in a provisional general scope returning to medical practice in New Zealand. -
Supervision report for IMGs on a provisional vocational or special purpose scope doing telemedicine, pathology, diagnostic and interventional radiology, public health medicine and medical administration.
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Special purpose - postgraduate trainee report: progress towards learning objectives and comments about supervised practice.
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Supervision report form for doctors on General scope or vocational scope.
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Use this form to verify your documentation by Statutory Declaration
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Special Purpose: Visiting Expert - Application for approval of invitation and supervision
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CV template when applying for VOC3
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Request for re-evaluation of application for registration within a vocational scope of practice
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PGY2-OSER - Application for removal of PGY2 endorsement after completing PGY2 year overseas or when when referred to Council by Advisory Panel
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New Zealand and Australian graduates: This checklist will help you to confirm your eligibility for registration, tell you what documents you need to provide, and will tell you what documents you need to have verified at source by EPIC.
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Postgraduate training - Checklist for registration in New Zealand
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Research - Part A: Checklist for registration in New Zealand
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CHKL3: Passed approved examinations
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Checklist 4: Comparable health system - checklist for registration in New Zealand.
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Australian general scope pathway - Part A: Checklist for registration in New Zealand
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Form that needs to be completed in order to apply for a partial refund of your practising certificate fee if your income for the year was below the threshold.
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NZREX Clinical - Checklist of documentation that must be provided with application.
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NZREX Clinical - Application for recount of result
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FORM SUPERSEDED - Please use the new REG12 form
Application for a practising certificate for international medical graduates registered on a provisional vocational scope returning to medical practice in New Zealand -
This form outlines the additional information that will be required by the RACP so they can provide us with advice on your application for vocational registration in sexual health medicine.
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This form further outlines the additional information that will be required by the RANZCO so it can provide us with advice on your application for vocational registration in ophthalmology.
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This form outlines additional information required by ANZCA for applications in anaesthesia.
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In addition to completing the RACP Additional Information Form, complete these supplementary specialty-specific questions for Cardiology.
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In addition to completing the RACP Additional Information Form, complete these supplementary specialty-specific questions for gastroenterology.
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In addition to completing the RACP Additional Information Form, complete these supplementary specialty-specific questions for neurology.
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In addition to completing the RACP Additional Information Form, complete these supplementary specialty-specific questions for rheumatology.
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Checklist 2: United Kingdom and Irish medical graduates - only for use with online applications made via myMCNZ
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This form outlines the additional information that will be required by the RANZCR so they can provide us with advice on your application for vocational registration in diagnostic & interventional radiology.
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This form outlines the additional information that will be required by the NZCPHM so it can provide us with advice on your application for vocational registration in public health medicine.
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This form outlines the additional information that will be required by the RANZCOG so it can provide us with advice on your application for vocational registration in obstetrics and gynaecology.
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In addition to completing the RACP Additional Information Form, complete these supplementary specialty-specific questions for clinical haematology.
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In addition to completing the RACP Additional Information Form, complete these supplementary specialty-specific questions for geriatric medicine.
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In addition to completing the RACP Additional Information Form, complete these supplementary specialty-specific questions for infectious diseases.
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In addition to completing the RACP Additional Information Form, complete these supplementary specialty-specific questions for medical oncology.
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Checklist 13: Special purpose - locum tenens - only for use with online applications made via myMCNZ
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This form outlines the additional information that will be required by the RACP so they can provide us with advice on your application for vocational registration in palliative medicine.
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This form outlines the additional information that will be required by the RACP so they can provide us with advice on your application for vocational registration in rehabilitation medicine.
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This form outlines the additional information that will be required by the RACP so they can provide us with advice on your application for vocational registration in occupational medicine.
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This form outlines the additional information that will be required by the CICM so they can provide us with advice on your application for vocational registration in intensive care medicine.
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PGY2-OS - Application for pre-approval to complete PGY2 overseas
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This form outlines the additional information that will be required by the RACP so they can provide us with advice on your application for vocational registration in public health medicine.
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This form outlines the additional information that will be required by the RANZCP so they can provide us with advice on your application for vocational registration in psychiatry.
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In addition to completing the RACP Additional Information Form, complete these supplementary specialty-specific questions for general medicine.
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In addition to completing the RACP Additional Information Form, complete these supplementary specialty-specific questions for respiratory medicine.
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In addition to completing the RACP Additional Information Form, complete these supplementary specialty-specific questions for neonatal and perinatal medicine.
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This form lists the additional information the RACS requires if you're applying for vocational registration in cardiothoracic surgery, general surgery, neurosurgery, orthopaedic surgery, otolaryngology head & neck surgery, paediatric surgery, plastic & reconstructive surgery, urology, and vascular surgery.
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This form outlines the additional information that will be required by the RNZCGP so it can provide us with advice on your application for vocational registration in general practice.
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If you have concerns about a registered doctor, you can refer the matter to the Council.
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Musculoskeletal medicine involves the diagnosis and treatment (or referral) of patients with neuro-musculoskeletal dysfunction, disorders and diseases, most of whom present with acute or chronic pain problems.
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Emergency medicine is a field of practice based on knowledge and skills required for the prevention, diagnosis and management of acute and urgent aspects of illness and injury affecting patients of all age groups with a full spectrum of undifferentiated physical and behavioural disorders.
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If a doctor has an issue with their own health, wherever possible we try to help them to remain in practice while it is being resolved. That said, our primary objective is to protect the health and safety of the public - which may mean that the doctor will be unable to practise safely, or will be limited in what they can do, until they are well enough to fully resume practice.
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Palliative medicine is the medical care that improves the quality of life of patients and their families and whanau facing the problems associated with life-threatening illness. The focus of palliative medicine is the anticipation and relief of suffering of patients by means of early identification, assessment and management of their pain and other physical, psychosocial and spiritual concerns. In particular, it affirms life, regards dying as a normal process and intends to neither hasten nor postpone death.
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Urology is the diagnosis and treatment (operative and non operative) of patients with disorders of the urinary tracts in males and females, and male genital organs. It also includes the management of trauma to these organs and the management of male sterilisation, infertility and sexual dysfunction.
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Oral and maxillofacial surgery involves the diagnosis and treatment (operative and non-operative) of patients with diseases, injuries and defects of the mouth, jaws and associated structures. This includes oral and maxillofacial pathology, trauma, dentoalveolar surgery, orthognathic and relevant reconstructive surgery, and facial pain.
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Clinical genetics is the investigation, diagnosis of and provision of medical advice, assessment and management of patients in relation to inherited genetic and chromosomal disorders and predispositions.
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Family planning and reproductive health is the treatment of and provision of health services for patients in relation to contraception, reproductive health and associated primary sexual health issues.
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Collegial relationships are a component of recertification for general registrants, doctors working outside of their vocational scope of practice, and in select cases doctors limited to non-clinical practice.
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Vascular surgery is the diagnosis and treatment (operative and non operative, including endoluminal techniques and interventional procedures) of patients with disorder of the blood vessels (arteries and veins outside the heart and brain) and the lymphatic system. It also includes the management of trauma and surgical access to the vascular system.
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Occupational medicine involves the study and practice of medicine related to the effects of work on health and health on work. It has clinical, preventive and population based aspects.
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Paediatrics involves the assessment, diagnosis and management of infants, children and young people with disturbances of health, growth, behaviour and/or development. It also addresses the health status of this group through population assessments, intervention, education and research.
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Medical administration is administration or management utilising the medical and clinical knowledge, skill and judgement of a registered medical practitioner, and capable of affecting the health and safety of the public or any person.
This may include administering or managing a hospital or other health service, developing health operational policy, or planning or purchasing health services. Medical administration does not involve diagnosing or treating patients. -
General surgery is a broad based specialty which includes the diagnosis and treatment (operative and non operative) of patients with disorders of the colon and rectum, upper gastro-intestinal organs, breasts, endocrine organs, skin and subcutaneous structures, blood vessels (including varicose veins) and the head and neck region. It also includes the early and ongoing management of trauma.
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Dermatology is the study, research and diagnosis of disorders, diseases, cancers, cosmetic, ageing and physiological conditions of the skin, fat, hair, nails and oral and genital membranes.
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Pathology involves the assessment and diagnosis of patients with diseases. Includes anatomical pathology (including histopathology), chemical pathology, forensic pathology, general pathology (a mix of anatomical and clinical pathology), genetic pathology, haematology, immunopathology, and microbiology (including virology).
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Sexual health medicine is concerned with sexual relations, including freedom from sexually transmissible infections (STIs), unplanned pregnancy, coercion and physical and psychological sexual discomfort. Its practice encompasses a wide range of factors that contribute to STIs, sexual assault, sexual dysfunction and fertility.
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Internal medicine involves the diagnosis and management of patients with complex medical problems which may include internal medicine, cardiology, clinical immunology, clinical pharmacology, endocrinology, gastroenterology, geriatric medicine, haematology, infectious diseases, medical oncology, nephrology, neurology, nuclear medicine, palliative medicine, respiratory medicine and rheumatology.
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Our registration application forms include a range of 'fitness for registration' questions. This page will help guide you should you need to make a declaration about any issues that might affect your fitness for registration.
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Every doctor in New Zealand must be registered to practise medicine. If you are not eligible for registration under any other pathway, you must sit and pass the NZREX Clinical, our registration examination.
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Cardiothoracic surgery is the diagnosis and treatment (operative and non operative) of patients with disorders of structures within the chest including: the heart and vascular system, the lungs and trachea, the oesophagus, the diaphragm and chest wall. It includes the management of trauma and congenital and acquired disorders of these structures.
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Otolaryngology, head and neck surgery is the diagnosis and treatment (operative and non operative) of patients with disorders of the ears, nose, throat, and related structures of the head and neck. This includes cancer of the head and neck (excluding the eye and the brain), disorders of the salivary glands and thyroid gland, disorders of hearing, balance, swallowing, speech, snoring/sleep apnoea and aspects of facial plastic surgery.
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Vocational registration is a form of permanent, specialist registration which allows you to work independently in New Zealand.
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Anaesthesia is the provision of anaesthetics, peri-operative care, intensive care and pain management to patients and can include the provision of resuscitation, retrieval/transportation (inter and intra hospital) and hyperbaric medicine to patients.
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Vocational registration is a form of permanent, specialist registration which allows you to work independently in New Zealand.
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Rural hospital medicine is determined by its social context, the rural environment, the demands of which include professional and geographic isolation, limited resources and special cultural and sociological factors. It is invariable practised at a distance from comprehensive specialist medical and surgical services and investigations.
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General practice is an academic and scientific discipline with its own educational content, research, evidence base and clinical activity, and a clinical speciality orientated to primary care. It is personal, family, and community-orientated comprehensive primary care that includes diagnosis, continues over time and is anticipatory as well as responsive.
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Rehabilitation medicine is the medical care of patients in relation to the prevention and reduction of disability and handicap arising from impairments, and the management of patients with disabilities from a physical, psychosocial and vocational viewpoint.
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Paediatric surgery is the diagnosis and treatment (operative and non operative) of children (usually up to 15 years of age) who may require surgery. It includes non-cardiac thoracic surgery, general paediatric surgery, oncological surgery, urology in children and the management of congenital abnormalities both ante-natally and in the neonatal period. Also included is the management of major trauma in children.
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Council requires all doctors in PGY2, to satisfy the requirements of a programme ordered by Council under section 40 of the HPCAA.
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Internet, email, and other forms of electronic communication are ways in which doctors communicate with patients and other health professionals, find information, and participate in informed discussion. This statement guides doctors on the use of email and other forms of social media.
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You cannot work outside the requirements of your scope of practice and any requirements set by Council specific to you. These are shown on your practising certificate. If you are registered within a provisional general, provisional vocational or a special purpose scope of practice, you need our approval of any change to your employment, supervision, position or location.
Once we've received and approved your variation application we will issue you a new practising certificate. -
Orthopaedic surgery is the diagnosis and treatment (operative and non operative) of patients with disorders of the musculoskeletal system (bones, joints, ligaments, tendon and peripheral nerves). It includes the management of trauma to the musculoskeletal system and the management of congenital and acquired disorders.
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If you trained and qualified as a specialist outside of New Zealand and Australia and wish to work in New Zealand as a specialist you can apply based on overseas training and qualifications and we will assess your case on its merits.
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Diagnostic and interventional radiology is the diagnosis and treatment of patients utilising imaging modalities, including general radiography, angiography, fluoroscopy, mammography, ultrasound, computed tomography, magnetic resonance imaging, nuclear medicine and bone densitometry.
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This form outlines the additional information that will be required by the RACP so they can provide us with advice on your application for vocational registration in internal medicine.
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Neurosurgery is the diagnosis and treatment (operative and non operative) of patients with disorders of the central, peripheral and autonomic nervous system including their supportive structures and blood supply. This includes the skull, brain, meninges, spinal cord, spine and pituitary gland. It also includes the management of traumatic, neoplastic, infective, congenital and degenerative conditions of these structures and surgical pain management.
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Pain medicine is the biopsychosocial assessment and management of persons with complex pain, especially when an underlying condition is not directly treatable. The scope of pain medicine supplements that of other medical disciplines, and utilises interdisciplinary skills to promote improved quality-of-life through improved physical, psychological and social function.
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A Professional Conduct Committee (PCC) is an investigatory body appointed by the Council. Its purpose is to investigate matters and concerns referred to it by the Council about a registered doctor. Although a PCC is appointed by the Council, it is separate from the Council, and regulates its own procedures.
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We sometimes require that a doctor has a chaperone present to observe their consultations with patients. We do this to mitigate risk to the patient where there are concerns that the doctor poses a risk of harm or serious risk of harm to the public. This is different from when a chaperone is present as a matter of good medical practice.
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You are eligible for a 50 percent refund of your practising certificate fee if your medical income (including any tax) in New Zealand or overseas is NZ$20,000 or less.
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Plastic and reconstructive surgery is the diagnosis and treatment (operative and non operative) of patients requiring the restoration, correction or improvement in the shape and appearance of the body structures that are defective or damaged at birth or by injury, disease, growth or development. It includes all aspects of cosmetic surgery.
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Obstetrics and gynaecology involves the diagnosis and management of patients in the area of reproductive health and diseases, including but not limited to women’s health issues, maternal foetal medicine, gynaecological oncology, reproductive endocrinology and infertility, and urogynaecology, male sexual disorders, post and perinatal issues.
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Psychiatry involves the assessment, diagnosis and treatment of patients with psychological, emotional, or cognitive problems resulting from psychiatric disorders, physical disorders or any other cause.
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Sport and exercise medicine is the medical care of the exercising individual, including the assessment and management of patients with musculoskeletal injuries and medical problems arising from sporting activity. Sport and exercise physicians possess expertise in general medicine, orthopaedics and rehabilitation, plus allied sport sciences including nutrition, biomechanics, exercise physiology and sports psychology.
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You can apply for registration via this pathway if, within the last five years, you have passed either the New Zealand Registration Examination (NZREX Clinical); or Part 1 and Part 2 of the Professional and Linguistic Assessments Board (PLAB) test.
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Special purpose registration is a temporary form of registration, for specific purposes. It is not a pathway to permanent general or vocational registration. Entry on the Register is cancelled after a fixed time period.
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Radiation oncology is the medical care and management of patients with cancer and other medical conditions through the conduct and supervision of radiation treatment, advice and provision of palliative and other supportive care, and advice and provision of other non-surgical cancer; advice and provision of other non-surgical cancer treatment including cytotoxic, hormonal and other drug therapies; participation in clinical trials and research related to cancer management.
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If you hold an approved postgraduate medical qualification from the UK, Ireland or Australia and intend to work as a specialist in Aotearoa New Zealand in an approved area of medicine, you can apply via the VOC4 fast-track pathway.
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The special purpose visiting expert scope of practice enables doctors to come to New Zealand to proctor, demonstrate, assist or teach a new or existing procedure to New Zealand practitioners for a maximum of one week.
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We may sometimes use terms you won't be familiar with. Find out here what they mean.
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Intensive care medicine involves the diagnosis and treatment of patients with acute, severe and life-threatening disorders of vital systems that are medical, surgical or obstetric in origin, and whether adult or paediatric.
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The Performance Assessment Committee (PAC) is made up of two medical members and a lay member. The PAC can assess a doctor’s performance at any time.