My membership

Change indemnity details

Change your indemnity details

Change indemnity details

Change your indemnity details

Title
First name
Last name
Membership number
Email address
Name of hospital/practice
Work address
Work postcode
Start date of new work
End date of new work
Grade/level of responsibility? (e.g. consultant, GP principal)
Are you in a formal deanery approved training post?
Is it a formal ST post?
What specialty are you in?
Give a brief outline of your role, including the training level if applicable, and any new work or procedures you will be undertaking.
How is this work supervised?
If supervised, what is the grade of the supervisor? (e.g. consultant, GP etc.)
Is this work indemnified?
How many hours per week will you spend doing this work?
If this work is not indemnified, how much will you earn?
Is this work instead of, or part of, your current post?
Please list any appropriate training and relevant experience for this work
Will you be using any new technology? e.g. lasers
Gross non-indemnified income you will earn from the start of this work until your renewal date?
Net non-indemnified income you will earn from the start of this work until your renewal date?
Please provide any other relevant details