SuppoRTT Pre-Absence Form

Basic Details

Please note that by using this form, you agree to HEE's latest privacy statement which can be found here: https://www.lpmde.ac.uk/professional-development/files/confidentiality-policy-may-2018

If possible, this form should be completed by the trainee and their Educational Supervisor/Training Programme Director, before the trainee is due to go on absence.

The return to work scheme is compulsory for absences of 3 months or more but can be opted into for absences less than 3 months if trainee or Educational Supervisor feel it is necessary.

Trainee First Name: Required

Trainee Last Name: Required

Trainee Email Address: Required

Please enter a valid email address.

GMC/GDC or other professional registration number: Required

Stage of Training: Required

Other:

Position/Grade: Required

Other (please state):

Medical or Dental Specialty? Required

Specialty Required

If other, please specify: