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Expressions of interest for practices to host a GPEP1 registrar in 2023/2024
1.
Please select your region
Northland
Auckland North West
Auckland Central
Auckland South
Waikato
Taranaki
Bay of Plenty
Hawkes Bay
Gisborne
Manawatu
Wellington
Nelson/Marlborough
Canterbury
West Coast
Canterbury
Otago/Southland
2.
What is the name of your Practice?
3.
What is the physical address of your practice?
4.
What is the postal address of your practice? (if different from above)
5.
Please enter the HPI ID (If known) for your practice
*
6.
Does your practice have Cornerstone Accrediation?
(Required.)
Yes
No
Other (please specify)
7.
Does your practice have Teaching Practice Accreditation?
Yes
No
Other (please specify)
8.
What is the name and email addresss of your Practice Manager
Name
Email Address
9.
What is the name and email address of your key contact for GPEP? (if different from above)
Name
Email Address
10.
Please list the accredited teachers that will be involved in the registrars teaching
Name
Name
Name
Name
Name
11.
Please list all the years that you have had a registrar in the past
12.
Does your practice identify as a hauora Māori provider or Māori practice
Yes
No
13.
If yes, which of the following statements apply?
We are a Health Provider privately-owned by a majority or all-Māori shareholding
We are a Health Provider owned by an iwi, hapū or other kaupapa Māori community organisation
We are a Health Provider owned by another kaupapa Māori corporate framework
Other (please specify)
14.
Does your practice identify as a Pasifika Health Provider or Pasifika Health Practice?
Yes
No
Other (please specify)
15.
If yes, which of the following statements apply?
We are a Health Provider privately-owned by a majority or all-Pasifika shareholding
We are a Health Provider owned by a Pasifika community or church organisation
We are a Health Provider owned by another Pasifika corporate framework
Other (please specify)
16.
What is the Characteristics/Demographics of your training practice?
Rural
Provincially Rural
Urban
High Needs
High Maori patient base
High Pasifika patient base
High Immigrant patient base
High proportion of one age demographic eg Under 5 or over 65.
If there is a high proporation of age please list below
17.
Does your practice offer specialist services?
eg skin or podiatry clinics?
18.
Anything else that is not listed above that could be beneficial to a registrar’s learning experience?
Examples could include providing accommodation, access to wider health services, community activities or outreach services which the registrar could participate in like school/community clinics.
19.
Can your practice provide the registrar with after hours or on call experience?
No
Yes, please specify below
20.
Are there languages your practice staff are fluent in?
21.
What type of registrar would you prefer?
Please note if you are interested in a College Employed registrar you will be required to complete a Health and Safety check which is our obligations under the Health and Safety Act. Also if you are a new training practice you will be required complete a Health and Safety pre-qualification form.
College Employed
Practice Employed
Have capacity for both College and Practice Employed at your Practice
Other (please specify)
22.
Would you prefer your registrar to be full time or part time?
Full Time
Part Time
Either Full time or Part Time
23.
If you could take a College Employed registrar can you please advise of your capacity to host during the year
First Attachment Only (30 January 2023-28 July 2023)
Second Attachment Only (31 July 2023-26 January 2024)
We could have a registrar in both attachments
We could have two registrars per attachment
We are unable to take a registrar for the next intake
Other (please specify)
24.
If there is anything else you would like the College to be aware of in your ability to host a registrar please provide it below
Current Progress,
0 of 24 answered