Placement Feedback

GP Registrar Placement Feedback Form

An initiative of the Registrar Liaison Officers, this form is designed to provide feedback about your placement. Please complete all fields before sending, once complete click the Send button if you wish to start again click the Reset button this will clear all the fields. This form will be sent to the RLOs and Trainers for discussion and review prior to being published on the website.

It is intended that feed back provided will be published on the website as a link under community / placement profiles.

Location of Placement: Community / township name	Placement location (Clinic / Hospital name)
Local Attractions: Weather / Sports and recreation / Arts and entertainment and any other highlights.
Accommodation and relocation arrangements: Comment on relocation and accommodation arrangements and details.
Hours actually worked: Details of hours actually worked while on placement including: Clinic / hospital opening hours and breaks.
After-hours and oncall: Details of after-hours or on call requirements while on placement including any arrangements as DMO.
Pay rate: Rate of pay on placement and any oncall rates
Supervision provided: Details on formal and informal teaching and or tutorials
Patient Demographics / Clinic Special Interests: Overview of patient base and any particular special interests of the clinic. (eg: sports medicine, work health, aboriginal health)
Suitability: Comments about suitable candidates for the placement
Comments by:
Name:	Contact Details
Dates of Placement: