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Locum Work Request
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Email
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Your email
Your Name
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Your answer
RCVS Number
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Your answer
Locations/Areas you would like to work
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Your answer
Tell us a bit about your skills and locum experience to date:
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Your answer
What would be your desired working hours, per week please? Weekends/ OOH’s?
Your answer
What are your areas of particular interest? Are there any areas of work you would like to avoid?
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Your answer
Are there any areas in which you feel you need additional support?
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Your answer
How would you like to be paid? If multiple options available please include all here.
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Ltd Company
Sole Trader
Umbrella
PAYE (zero hours)
What is your rate? Day/Hour. If different rate for weekends or OOH please state.
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Your answer
What is your current availability?
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Your answer
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