2027 GP Supervisor Availability

2027 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 2027 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 *

GP Supervisor(s) Information

Please provide required details of GP's and GP Registrar's who will be sharing supervision of student placements below.

Important - If GPs at your practice prefer to supervise students 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:

GP Supervisor 2: First Name

GP Supervisor 2: Last Name

GP Supervisor 2: AHPRA #

GP Supervisor 2: Email address

GP Supervisor 2 Comments:

GP Supervisor 3: First Name

GP Supervisor 3: Last Name

GP Supervisor 3: AHPRA #

GP Supervisor 3: Email address

GP Supervisor 3 Comments:

Does your practice have additional GPs or GP Registrars sharing student supervision? Please select YES and our team will contact you to confirm details *

YesNo

2027 GP Availability

Please select your availability preferences below to supervise Medical Students in 2027:

2027 GP Medical Student Placement Schedule

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 agreeNo I do not 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 agreeNo I do not agree

This form was completed by: *

Date Completed and Submitted *

NEXT STEPS

Thank you for your submission to participate in the 2027 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: gcphn.org.au/wp-content/uploads/2024/08/GCPHN-GP-Supervisor-Onboarding-Guide.mp4 and once you have completed the video, please fill out this form: 2027 GP Onboarding Video Confirmation.

PRIVACY

We take privacy and security extremely serious. 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 more information about the program: Medical Student Clinical Placements - Gold Coast Primary Health Network (gcphn.org.au)

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