New starter form

This form is for new Doctors joining EKHUFT. This will need to be completed in full ready for IT access to be created for the main hospital network and some other IT systems which you will require when you start with the Trust. This will also enable the Trust to begin completing ID checks required for your ID and Smartcard badges.

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 with EKHUFT 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 which will give you access to national systems, clinical data and patient information.

It is important 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.

Please be aware any photograph you upload will also be used for your EKHUFT ID Card.

Note: If, however you are returning to our Trust the above paragraph will not apply to you.

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 confirm that I will bring 1 x form of Photo ID with me on the day of the Induction to be verified if I have completed all required from this form

I will bring 3 forms of ID to my Induction to include 2 x photo ID and 1 x name and address for a full ID check to take place if I have not responded to the National email request in time for apply for NHS care ID identity for an NHS Smartcard

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