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Psychiatry Division
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Permanent Recruitment Division
Psychiatry Division
GP Division
Permanent Recruitment Division
To register with Direct Medical Services please complete the following form. When you have finished please press the SUBMIT Button to forward your details to us by email. Thank you for your time in completing this form.
Name:
E-mail:
Address:
Postcode:
Telephone:
Mobile Telephone
(if applicable)
Work Type:
Select one:
Permanent only
Locum only
Permanent & Locum
Speciality:
Select one:
GP
Psychiatrist
Hospital Doctor
Medicine
Surgery
Anaesthetics
A & E
Radiology
Obs & Gynae
Paediatrics
Ophthalmology
ENT
Other
If other please specify:
Speciality Grade:
GMC No:
Availability:
Date From:
Date Until:
Additional Info:
Once you have submitted your application confirmation will be sent and a Recruitment Consultant will be in contact with you shortly.
Thank you for your time.
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