2026 GP Supervisor Availability Form

2026 GP Medical Student Placement Program Availability

Bond and Griffith University, in collaboration with the Gold Coast Primary Health Network (GCPHN) Clinical Placements team, warmly invite you to participate in the 2026 GP Placement Medical Student Program.

To provide your availability to host students please complete the form below.

If you need assistance completing the form or have any questions, please contact us via:

Phone:07 5612 5402 Mobile:0429 000 040 or email: clinicalplacements@gcphn.com.au

Practice Details

Practice Name *

Practice Manager Salutation *

Practice Manager: First Name *

Practice Manager: Last Name *

Street Address *

Suburb *

Postcode *

State *

Practice Phone Number *

Practice Email Address (please use generic email where possible) *

GP Supervisor(s) Information

Please provide required details of GP's and GP Registrar's who will be supervising student placements below. If GPs at your practice prefer to supervise student independantly, please complete a separate form for each GP.

GP Supervisor 1: First Name *

GP Supervisor 1: Last Name *

GP Supervisor 1: AHPRA # *

GP Supervisor 1: Email address

GP Supervisor 1 Comments: Example-Dr doesn't work on Mondays and half days Thursdays, Dr has a special interest in..

GP Supervisor 2: First Name

GP Supervisor 2: Last Name

GP Supervisor 2: AHPRA #

GP Supervisor 2: Email address

GP Supervisor 2 Comments: Example-Dr doesn't work on Mondays and half days Thursdays, Dr has a special interest in..

GP Supervisor 3: First Name

GP Supervisor 4: Last Name

GP Supervisor 3: AHPRA #

GP Supervisor 3: Email address

GP Supervisor 3 Comments: Example-Dr doesn't work on Mondays and half days Thursdays, Dr has a special interest in..

If your practice has additional GPs or GP Registrars sharing student supervision, please let us know here and our team will call to collect and confirm details: *

YesNo

GP availability to supervise medical students in 2026

Please select preferences below to supervise medical students in 2026. For detailed information regarding supervisor responsibilities, please refer to: Medical Student Clinical Placements - Gold Coast Primary Health Network

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Griffith University Medical Students: By submitting this form, you confirm your intent to supervise Griffith University medical students and acknowledge your agreement to the supervisory obligations and documentation requirements as outlined in the university specific Student and Supervisors Handbook provided by GCPHN.

Yes I agree

Bond University Medical Students: By submitting this form, you confirm your intent to supervise Bond University medical students and consent to receiving a university-specific service agreement directly from Bond University via email.

Yes I agree

This form was completed by: (please provide full name) *

Date Completed and Submitted *

NEXT STEPS

Thank you for your submission to participate in the 2026 Medical Student Placements program.

Prior to being assigned medical students, we do ask that all GPs & GP registrars participating in the program watch the GCPHN GP Supervisor Onboarding Video that provides a comprehensive overview of the program and associated GP Supervisor requirements. To do this please watch this video in full: https://gcphn.org.au/wp-content/uploads/2024/08/GCPHN-GP-Supervisor-Onboarding-Guide.mp4 and complete this:https://gcphn.snapforms.com.au/form/2025-gp-onboarding-video-confirmation.

Practice documentation for Semester 1, 2026 will be emailed to practices assigned with students in the first few weeks of December 2025.

Semester 2, 2025 student allocations and practice documentation will be sent mid 2026.

PRIVACY

We take privacy and security extremely seriously. By providing us with your information you agree to how we store your data. To find out more visit our website at: Privacy Policy - Gold Coast Primary Health Network (gcphn.org.au)

To find out in more detail about the program please go to:Medical Student Clinical Placements - Gold Coast Primary Health Network (gcphn.org.au)

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