Application form

Clinical Expert Panel

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If you have not had any experience in participating in an investigation team your application will not be supported. We recommend that you contact your local director of clinical governance for advice on opportunities to gain experience in investigations.

Contact details

Your role and background

Experience in rural or remote practice? *
Are you currently engaged in clinical practice? *
Do you identify as Aboriginal or Torres Strait Islander? *
Are you culturally and linguistically diverse? *

Qualifications and registration

Any restrictions on registration or practice? *
Any serious past complaints or being investigated? *
Any significant past or pending litigation? *

Experience with investigations

Have you been a member of a Serious Adverse Event Review (SAER) team?
Do you participate in local SAER investigations or internal reviews?
Have you received SAER training conducted by the CEC?
Have you participated in other high-level reviews or investigations?
Have you undertaken any other training that would assist you in undertaking a review or investigation?
Have you completed any relevant studies where the principles of investigations were included in the course?

Reason for application

Referees

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