Get Canada Memorial University Of Newfoundland Moonlighting (final Year Specialty Locum/er-gp Locum) 2021-2025

This guide provides comprehensive instructions on how to accurately complete the Canada Memorial University Of Newfoundland Moonlighting Request form for Final Year Specialty Locum and ER-GP Locum. Follow these steps to ensure your application is submitted correctly and on time.

Follow the steps to successfully complete the Moonlighting request form.

1. Press the ‘Get Form’ button to access the Moonlighting Request form and open it for editing.
2. Begin by entering your name in the designated field to identify yourself.
3. Fill in your program details in the appropriate section.
4. Provide your email address to receive confirmation or further instructions.
5. Indicate your PGY level in the specified box.
6. Enter your CMPA code (if applicable) in field 14.
7. Confirm your current Advanced Cardiovascular Life Support (ACLS) status by checking 'Yes' or 'No'. If 'Yes', ensure the date is within two years. Specify if you intend for locums in Anesthesia, Emergency Medicine, General Surgery, Internal Medicine, GIM, Obstetrics-Gynecology, or Critical Care.
8. Complete the section for your scheduled rotation at the time of the locum.
9. Enter the location of your locum work in the designated field.
10. Fill out the requesting Division Head/Site Chief's name and obtain their signature where indicated.
11. Mark the start date and time of your locum by using the 24-hour clock format.
12. Similarly, complete the end date and time fields using the 24-hour clock format.
13. If submitting a leave request, ensure that it has been approved prior to the starting date of the locum.
14. Complete the Annual Leave section if applicable, ensuring it does not compromise your rotation.
15. Sign the learner signature field and date it to certify the accuracy of the information provided.
16. Obtain the program director's signature and date.
17. This form is recorded by PGME and requires the recorded date to conclude the process.
18. Finally, check that the form has been received at PGME and emailed to the CPSNL and Health Authority.

Complete your documents online to ensure all submissions are timely and compliant.