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Application to join OEUK's Registered Doctors List
Personal Details
Please note: The email address and telephone number entered below will only be used by OEUK to keep in touch with you and to distribute relevant information. This information will not be published on our website.
First name
Last name
Email Address
Telephone
Year of qualification
Postgraduate degrees/diplomas
Medical registration
Please enter the details of your medical registration with the UK General Medical Council in the fields below to allow OEUK to verify your registration and process your application. Your registration body will be the General Medical Council (GMC) and your Registration Number will be your GMC Reference Number.
GMC Reference Number
Clinic details
Please note: the clinic email address and telephone number entered below will be displayed on the registered doctors list on our website to allow prospective patients to get in touch with you after your application has been accepted.
Name of Clinic
Address line 1
Address line 2
Address line 3
City
County/Region
Postcode
Country
Clinic email address
Clinic telephone
Relevant experience
Please select the option that best describes your practice in occupational medicine
Occupational Physician working principally in the oil industry
Occupational Physician working partly in the oil industry and partly in other industries
A Physician whose primary substantial clinical work is in another medical speciality, but with a part-time occupational medicine element
None of the above
If you selected 3 or 4 above, please state your main area of clinical practice:
Your personal relevant experience
Please describe your experience, past and present, in offshore oil and gas medicine
Please describe your experience, past and present, in any other form of remote medicine
Please describe your present activities in occupational medicine
Please describe your reason(s) for requesting entry to the examining doctor list (i.e. what are the circumstances that require you to undertake OEUK medicals?)
Your practice
How would you describe your organisation
Oil & Gas Operating Company
Oil & Gas Related Contractor Company
General Practice or other Medical Clinic
Self-Employed Business
Other
If you selected Other, please indicate your organisation type below
Facilities
Please provide the following details: Audiometer make and model, acoustic booth details and other relevant information relating to meeting the requirements of BS EN ISO 8253-1:2010
Attach a copy of your current audiometer calibration certificate at the end of this form. Applications submitted without a certificate will not be processed.
Certain offshore workers may be designated as emergency response team members and require a higher level of physical fitness than standard offshore workers. The Medical Guidelines require these workers to undergo further evaluation including a fitness test and determination of VO2 max. This may be by Chester Step Test or any other suitable testing method. Provide details of VO2 max test to be used
Declaration
By clicking the checkbox below, I certify that the above information is correct. If included on the Registered Examining Doctors List, I agree to adhere to the OEUK Guidelines for Medical Aspects of Fitness for Offshore Work and to have my services audited by OEUK. I certify above information is correct
Attach a copy of your current audiometer calibration certificate here. To upload multiple files, press ‘Choose files’ button and hold down the ‘Ctrl’ key on your keyboard to select multiple files.
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