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Peer to peer support enquiries

This form is optional. It is designed to help us support you in the most appropriate way. All information provided will be in strictest confidence and will not be linked in any way to your membership record.

Personal details
If you chose other ethnic background, please specify:
Your role
Which of the following areas do you work in?

Have you been accused of:

If you have selected "other", please provide details here
Clinical Director involved?


Medical Director involved?


Are you on supervised practice?

Have you been suspended?

Have you been referred to the GMC?

Are other bodies involved e.g. NCAS?

If you chose "Other", please provide details
Data consent