To be considered, this form must be received by the College no later than five (5) working days after the completion of the examination.

The Committee for Examinations (CFE) requests that at the completion for the examination, you submit a brief report of any incident you believe may have an effect on the outcome of the examination. Further information regarding the incident report procedure can be found in the Exams Section of the College website under Complaints Resolution.

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* 1. Name of person making report:

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* 2. Date of the OSCE:

Date

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* 3. OSCE site:

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* 4. Time of OSCE:

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* 5. OSCE stream colour

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* 6. Affected station/s (please state station number/s):

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* 7. Please give a brief description of the incident, sufficient to enable the CFE to determine the suitable action.

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* 8. What is the main reason you are completing this form and what outcomes do you hope to achieve?

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