Get Ie Health Information And Quality Authority Personal Information Form

Completing the IE Health Information And Quality Authority Personal Information Form online is a crucial step in ensuring proper registration and management within designated centers. This guide will provide you with a clear approach to filling out each section of the form effectively.

Follow the steps to accurately complete the form online.

1. Click ‘Get Form’ button to obtain the form and open it for completion.
2. Begin with Section 1, which requests details about the designated center. Enter the center name and center ID as requested.
3. In Section 2, provide the contact details for the individual. Indicate their role by selecting the appropriate checkbox, and fill in their title, first name, surname, job title, start date, and contact information, including business phone number, mobile number (if applicable), and email address.
4. Proceed to Section 3 to confirm registration with a professional regulatory body. Here, you will need to enter the name of the professional body and the associated registration number, alongside the registration status.
5. For Section 4, list relevant qualifications and accredited training for the person. Include the name of each qualification, the awarding body, and the date of each award.
6. In Section 5, provide a comprehensive employment history. Document the start and end dates, employer's name and address, job title, position details, and reason for leaving for each employment. If necessary, continue on a separate photocopy of this section.
7. Next, in Section 6, verify if the individual has ever worked with vulnerable adults or children. Select 'Yes' or 'No' and, if applicable, complete the subsections regarding the verification of previous employment.
8. Finally, Section 7 requires a declaration by the registered provider. The authorized person must print their name, state their position, sign the form, enter the date, and provide a contact number for follow-up.
9. Once all sections are completed, you can save changes, download, print, or share the form as needed.

Complete the IE Health Information And Quality Authority Personal Information Form online to ensure accurate and efficient processing.