Simulated Patient Applications

For full details of the sessions, please see this page.

GEM Recruitment

First Name

Last Name

Phone/Mobile

Age (real, not playing age)

Where will you be traveling from?

City

How do you currently mostly identify?

Gender Identity

Minimum Playing Age

Maximum Playing Age

Tell us about yourself (optional)

Upload Headshot

Choose File

Upload CV (optional)

Choose File

If you have a website or link you would like to share, please add it here

I confirm I am registered as self employed with HMRC

Yes

Have you taken part in medical communication skills role-play before?

Yes

Please describe your experience in communication skills role-play

Have you self-facilitated communication skills sessions before?

Yes

Please describe your self-facilitation experience

I can attend an audition on the 1st of June at the Derby Royal Hospital

Yes

I consent to have this website store my submitted information so they can respond to my inquiry

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