Information for supervisors completing an employer reference form

  1. Summary
  2. Information for PAs and AAs completing an employer reference form
  1. Information for supervisors completing an employer reference form

What do I need to complete?

If you are the applicant’s supervising clinician or line manager, we need you to complete sections two and three of the employer reference form. The PA or AA applying for registration should have completed section one before the form is shared with you. Please check this, if this hasn’t been completed, or you notice any information is incorrect, please ask them to complete or amend this first.

Please note that there are two versions of the employer reference form. You should check that the applicant is using the correct one for their role:

How do I complete the form?

You can complete the form in the following way:

  • Use Adobe software where you can add electronic signature or upload a photo of your signature.
  • Print, add a handwritten signature, then scan the form
  • If you are unable to do the above, you can add a typed signature if needed but further checks will need to be made.

Section two

In this section, we need you to confirm the capacity in which the applicant was working.

We then need you to confirm if you are aware of any issues relating to their fitness to practise. If there are, we’ll need you to provide details on the form. 

Section three

This section requires you to enter your personal details so that we can verify the information provided.

Both your email address and telephone number should be your official work contact details, not your personal ones.

If you are supervising a PA or AA working in a clinical role, you must tell us your GMC reference number. If you are supervising a PA or AA who is working in a PA/AA educator role or in a non-PA/AA patient-facing healthcare role, you can leave that field blank (unless you have another registration number, for example a NMC PIN).

You should only sign and date the form if:

  • the information provided in the form is true and correct
  • you have checked with relevant local management that there are no ongoing investigations into the applicant's character, conduct or performance (other than any concerns outlined above)
  • you are not related to the applicant 

Need more help?

If you are still having issues completing the form, please contact us.

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