Recruiting, retaining and supporting General Practitioners (GPs), Nurses and Allied Health Professionals in rural New South Wales, Australia

Evaluate Your Locum Placement

Please note that fields marked with an asterisk (*) are required in order to successfully submit your evaluation.


Practice placement being evaluated by RDN Locum.
*Your Surname
*Your First Name
*Your Preferred Name
Your Other Names
*Telephone (Business Hours)
*Email
Practice:
*Practice Name
*Postal Address Line 1
Address Line 2
*Place Name
*State
*Country
*Postcode
*Placement Date Start DD/MM/YYYY)
*Placement Date End (DD/MM/YYYY)
*Have you worked in this practice prior to this placement?
Yes No
The Practice
*Rate the clinical handover of information from the GP to you

Highly
Satisfactory

Satisfactory

Unsatisfactory

Highly
Unsatisfactory

Unknown

NA
*Rate the standard of accommodation provided

Highly
Satisfactory

Satisfactory

Unsatisfactory

Highly
Unsatisfactory

Unknown

NA
*Rate the support and assistance of practice staff

Highly
Satisfactory

Satisfactory

Unsatisfactory

Highly
Unsatisfactory

Unknown

NA
*Was an adequate contacts list to gain access to other clinical staff in the local area provided?
Yes No
*Was the placement an enjoyable experience?
Yes No
If placement was not enjoyable, why?
*Did you have arduous off-duty domestic responsibilities? (e.g. pets, garden, etc.)
Yes No
If there where, what were they?
*Was the practice adequately prepared for your arrival?
Yes No
If no, what was lacking?
*Were the practice's expectations of an acceptable workload for you realistic?
Yes No
If no, please comment?
The Future
*Would you work as a locum in this practice again?
Yes No
If no, why not?
*Would you work as a locum in this town again?
Yes No
If no, why not?
What worked well?
What needs to improve?

I the above mentioned, by clicking the 'Submit my Evaluation' button, certify that the information contained herein is full and accurate.

 

Thank You. Please submit this form or print and return to

NSW Rural Doctors Network

locums@nswrdn.com.au

Ph: +61 2 49248000

Fx: +61 2 49248020

 

Program Manager - Medical Locums

NSW Rural Doctors Network

Level 3, 133 King Street

NEWCASTLE NSW 2300