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Reference request nhs form

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The document is a confidential reference request form for the Clinical Apprenticeship Scheme (CAPS), designed to gather information about a candidate doctor from their referee. It includes sections for candidate and referee details, questions regarding the doctor's professional abilities, conduct, communication skills, and overall suitability for a supernumerary post. The completed form is to be submitted to the CAPS coordinator.

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Click ‘Get Form’ to open it in the editor.
Begin with Part 1: Candidate Details. Enter the name of the candidate in the designated field.
Proceed to Part 2: Referee Details. Fill in your name, job title, postal address, and email address accurately.
In Part 3: Reference, provide details about your professional relationship with the Doctor. Specify the dates you worked together and describe your capacity.
Comment on the Doctor’s clinical abilities and their communication skills with patients. Use clear and concise language for effective feedback.
Complete additional observations regarding general conduct, timekeeping, teamwork, honesty, and integrity as required.
Finally, sign and date the form in the signature section before submitting it via email or post as instructed.

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