0.0 AMDS TRD Doctor Checklist
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<strong>AMDS</strong>/<strong>TRD</strong>—DOCTOR CHECKLIST<br />
<strong>Doctor</strong> Name …………………………………………………………………...<br />
Documents requiring signature<br />
Working in the Dark attendance register<br />
Medicare - Standard Prescription Order Form (must be printed not handwritten)<br />
Medicare - Authority Prescription Order Form (must be printed not handwritten)<br />
Medicare - Prescription Shopping Information<br />
Medicare - Request for Prescriber Bag Supplies Order Book<br />
Compliance Form<br />
NHDS Authority Consent<br />
Contact Details and Emergency Contact Details<br />
Banking Details and Car Details<br />
<strong>Doctor</strong> Bag Optional Item Order Form<br />
Evaluation Questionnaire (to be completed after orientation shift)<br />
To be returned to NHDS<br />
1 x photo of yourself –<br />
(email to belinda.marwe@homedoctor.com.au or jenny.may@homedoctor.com.au)<br />
Medical Indemnity Insurance<br />
Police Check<br />
(including working with children and vulnerable people clearance)<br />
ALS Certification<br />
Signed Services Agreement<br />
Mentor Meeting Group Preference
<strong>AMDS</strong>/<strong>TRD</strong>—DOCTOR CHECKLIST<br />
Electronic documents<br />
Definition of a Medical Deputising Service<br />
RACGP Membership Booklet<br />
ACRRM Membership booklet<br />
<strong>AMDS</strong> Program Guidelines<br />
Service Agreement and Schedule of Rates<br />
For your reference<br />
<strong>AMDS</strong>P/<strong>TRD</strong> After Hours Clinical Handbook 2016<br />
Roster Development timeline for doctors—handout<br />
Map—handout<br />
Health Information Sheet<br />
NHDS to action<br />
Connect Profile<br />
Observation Shift<br />
<strong>Doctor</strong> Bags<br />
Astute<br />
*Mandatory for <strong>AMDS</strong> doctors who are NOT in a GP Training program*<br />
<strong>AMDS</strong> Mentor Meeting confirmation<br />
<strong>AMDS</strong> Placement
<strong>AMDS</strong>/<strong>TRD</strong>—DOCTOR CHECKLIST<br />
DECLARATION<br />
I understand:<br />
<br />
<br />
<br />
<br />
The information as listed above is essential and I will not be permitted to work with NHDS until all of the above<br />
information is provided<br />
I must provide a signed services agreement to NHDS before commencing work<br />
My requirements to complete 4 online modules relating to doctor interpersonal skills within the first month of working<br />
with NHDS<br />
The requirement to attend 10 compulsory mentor meetings annually as part of the <strong>AMDS</strong> Program.<br />
Signed:<br />
<strong>Doctor</strong><br />
Signed:<br />
NHDS representative<br />
Date:
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