LOCUM REGISTRATION FORM

It takes less than 5 minutes to register if you have the following information ready:

  • Your GOC registration details
  • Your OPL number
  • Your insurance details (if applicable)
  • Your Bank Details
  • Your National Insurance Number
  • Your Clinical Referee contact details
  • Your safeguarding details (DBS Certificate (England & Wales) / PVG certificate (Scotland) / Access NI certificate (Ireland)
 

Please complete the form below

Do you have a legal right to work in the UK? *
Please select your locum type
Name *
Name
Gender
Address
Address
Date of Birth
Date of Birth
e.g. AOP number or details of other insurance
I am qualified, skilled and agree to carry out contact lens fittings & aftercare
Do you have any conditions applied to your GOC/NHS registration, or are you subject to any investigation currently?
NHS Regulations, require that practices are satisfied with the clinical references of Optometrists before they are engaged with the provision of GOS services.
If you have worked less than 3 years
Do you have your safeguarding details
DBS (England & Wales); PVG certificate (Scotland); Access NI certificate (Ireland)
Bank details required by some practices (to send you payments by BACS)
Which Practices have you worked for in the past?