Resident Doctors Form

This form is intended for Resident Doctors joining the NHS via EKHUFT for the first time. It is vital you complete this form with accurate information regarding your position.

On successful submission and approval of this form you will be in the position of having IT Access (including some of the main Clinical Sub-Systems) from your first day.

This form will also enable the initial processing of your ID Card & NHS Smartcard which will be ready for completion on the day of your induction based on succesful ID Checks.

Please see under the 'Terms & Conditions' Section for the ID required to complete your enrollment process.

ra01-doctors

Your details

Title ^*

First name ^*

Last name ^*

Middle name(s)

Preferred Name

National insurance number ^*

Date of birth ^*

Role / job title ^*

Department or ward ^*

Speciality ^*

Site ^*

Email ^*

Please use your existing NHS email address if you have one, if one is not used a new NHS email address will be created for you.

Existing NHSmail Account? ^*

Yes No

Mobile number ^*

IMPORTANT - required for applying for NHS Care ID/Smartcard

Professional registration ^*

GMC registration number for example

Welcome day

IMPORTANT- Please supply the date you will be attending your Welcome Day.

Final working day if known

Previously employed at another Trust?

Smartcard UUID

Enter the long number printed on the card.

I hold an existing smartcard which I will bring with me the day of my Induction ^*

Yes No

Reason for application

If this is your first time joining the NHS and you have successfully submitted this form, you will be contacted shortly via e-mail by ‘NHS Care ID’. This is for the purpose of creating an NHS Care ID Profile (via the 'Apply for Care ID Process') which will give you access to national systems, clinical data and patient information.

It is vital that you follow the instructions outlined in this e-mail as this will ensure you will be provided with your NHS Smartcard based on successful ID Checks at your local induction.

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If this is not your first time joining the NHS, please ensure you use the Photo Upload section below, in order to ensure accurate and up to date photos for your ID Card.

Please be aware any photograph you upload will also be used for your EKHUFT ID Card, Staff Photo Board & Medical Handbook.

Photo Upload

Please ensure you have uploaded a photo of yourself to be used for your NHS ID Card & NHS Smartcard.

To do this you can simply drag your photo in the box below or click to upload.

Your photos must:

1. Be clear and in focus

2. In Colour

3. Unaltered by computer software

4. At least 600 pixels wide and 750 pixels tall at least 50KB and no more than 10MB.

5. Contain no other objects or people and to be taken against a plain light-coloured background.

6. Be in clear contrast to the background, not have 'red eye', be facing towards and looking straight at the camera and have a plain expression.

7. Have your eyes open, visible and not have anything covering your face.

8. Not have hair in front of your eyes.

9. Not have a head covering (unless it's for religious or medical reasons).

10. Not have any shadows on your face or behind you

11. Ensure if you're using a photo taken on your own device it includes your head, shoulders and upper body. Do not crop your photo.

12. Not wear glasses in your photo unless you have to do so.
If you must wear glasses, they cannot be sunglasses or tinted glasses, and you must make sure your eyes are not covered by the frames or any glare, reflection or shadow.

Upload your photo

Drop files here or click to upload

Terms and Conditions

Before you attend the Induction it is advisable that you read the ‘NHS Smartcard: Terms & Conditions’ as you will be asked to sign as confirmation that you understand and will uphold the national standards before your Smartcard is released.

I have read, understood and accept these T&Cs

I can confirm that if eligible for the ‘Apply for Care ID Process’ that I will bring with me 1 form of photographic ID for verification. If not eligible, I can confirm that I will bring 3 forms of ID for a full ID check to take place before release.

Important: Please make sure you have completed all sections of the form for successful processing before clicking submit.