KCL PREHOSPITAL CARE PROGRAMME APPLICATION FORM

NURSING STUDENTS

Please complete our application form below. All fields are mandatory as this information is required for insurance/indemnity reasons.
Copies of documents may be uploaded as images (e.g. taken by camera). All applications are reviewed by the PCP team and will be processed within 10 working days.

This is used to contact you in case of emergency.
You must use your KCL email address (e.g. joseph.bloggs@kcl.ac.uk)

Please upload a copy of your RCN card

Please download and complete the following London Ambulance Service indemnity form. Please complete all 3 pages where indicated. Under 'Emergency Contact' please provide BOTH A NAME & PHONE NUMBER. Leave the 'call sign' and 'authorising manager' section blank.

We also require the details of your next of kin. This is so we can contact them in the case of an emergency or if you are involved in a road traffic collision whilst in the ambulance. It is also a requirement of the LAS for you to go on shift with them.

Your Indemnity form including NOK details will be accessible by all KCL PCP Paramedic mentors. It will be sent to the relevant LAS team in order to facilitate the shift.

Nursing students are required to submit their ongoing achievement record (OAR) pages from each placement they have completed. I.e. Nursing students at the end of 2st year will be required to submit 6 OARs, students at the start of their programmes will have no OARs to submit etc. This is a requirement from the nursing school and is not controlled by the PCP team. Any OAR issues will be considered on a case-by-case basis. Please feel free to get in touch with the PCP team if you have any concerns or questions about OAR.

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