Welcome to the Locum Connect Locum Registration Form
Before you get started, here is a list of the information you will need to complete this form.
- Please select your title
- Please enter a value
- Please enter a valid email address
- Sorry, that address already exists - if you already have an account with us, please try using the remember password option
- Passwords do not match
- Please select a value
- Please upload proof that you are eligble to work in the UK
- Uploaded file must not have apostrophes or commas in file name
- Please upload a copy of your current Indemnity Insurance
- You must be registered with the GPHC to continue on this site
- Please specify details of the Fitness to Practise issue
- Please specify details of the health issue
We can send you an email listing available shifts in your area. Please tick either of both of the options below if you would like to receive this.
- You must agree to the terms before continuing.
Please check the required fields.