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Overseas 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 This information will not be published on our website.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
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Last name
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Email Address
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Telephone
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Year of qualification
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Postgraduate degrees/diplomas
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Medical registration
National and/or State medical registration/licencing body
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Medical registration/licence number/code/reference
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Attach a current copy of your medical registration/licence from your National/State registration/licencing body at the end of the form.
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
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Address line 1
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Address line 2
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Address line 3
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City
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County/Region
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Postcode
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Country
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Clinic email address
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Clinic telephone
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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:
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Your personal relevant experience
Please describe your experience, past and present, in offshore oil and gas medicine
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Please describe your experience, past and present, in any other form of remote medicine
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Please describe your present activities in occupational medicine
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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?)
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Your practice
How would you describe your organisation?
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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
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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
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Attach a copy of your current audiometer calibration certificate at the end of the 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
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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
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Attach current copies of your medical registration/licence and 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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