Event Medical Team Application Form
Full Name
*
Date of Birth
*
/
Day
/
Month
Year
Date Picker Icon
Contact Number
*
Confirm Contact Number
*
Email Address
*
Confirm Email Address
*
Do you have any unspent criminal convictions as outlined in the Rehabilitation Act 1974?
*
Yes
No
If yes, give details here.
Do you have any mental or physical health conditions that would prevent you from working fully within your scope of practice, and potentially lifting, pulling, or pushing loads? If yes, give details below.
*
Yes
No
If yes, give details here.
Are you applying for a Welfare Team role?
*
Yes
No
Do you have a current and valid UK driving license?
*
No
B Class
C1 Class
CERAD or equilivant
What current Medical/Healthcare/Pre-Hospital qualifications do you hold?
*
None
First Aid
FREC3
FREC4
FREUC5
CMT
Emergency Medical Technician
NMC Registered Nurse
NMC Registered Mental Health Nurse
NMS Registered Midwife
HCPC Registered Paramedic
GMC Registered Doctor
HCPC Registered Physiotherapist
Safe Administration of Life Saving Medications
Immediate Life Support
Advanced Life Support
Event Control/Command
Do you have experience in any of the following?
Emergency Nursing/Medicine
Anaesthetics/ICU
Pre-Hospital
Events
If any, briefly explain your experience, and list any event medical companies in Northern Ireland that you have previously or currently work with?
What relevant skills can you offer Paragon Healthcare?
*
Please verify that you are human
*
Submit
Should be Empty: