External Adviser for ARCP: Request Form Please outline your request for an EA by completing the below form as fully as possible. Where you have multiple dates, please outline these in the box provided. We will endeavor to respond to your request within 14 days of receipt. Questions that require a response are indicated. Full Name Email address Region/Deanery Please select the request type - Select -ARCP Panel Session Please select the stage of training or specialty(s) that the request covers (you can select multiple answers as required). Stage 1 Stage 2 Stage 3 ACCS Anaesthetics Dual anaesthetics and ICM Please note: Every effort will be made to provide an external adviser with the relevant expertise; however, this may not always be possible. Please select the date of the panel Is the panel virtual or in person? Virtual only Virtual with the option to attend in person In person only Please note: it is much easier for external advisers to attend virtual panels. When they attend in person, the deanery would be expected to cover their travel and subsistence expenses. Where there are multiple dates, please add these below. Where there are multiple dates for multiple specialties, please provide details of this below for our records. Please provide a deadline for confirmation of attendance so that we can ensure a response is provided within a specified time frame. Additional information (please specify time/duration of panel if known) Confirmation Data Protection Statement The Royal College of Anaesthetists (RCoA) is fully committed to the principles of data protection, as set out in the Data Protection Act 2018 (C.12). The RCoA relies on legitimate interests as the lawful basis for processing of personal data. We process and maintain personal data about you so that we can manage your membership, provide you with appropriate products and services and share information with you about RCoA activities. We will only use your information for the purposes as described and will not pass on your details to other third parties unless you have given us consent to do so. We use appropriate organisational and technical measures to ensure that your data are secure and protected from loss, misuse and unauthorised access or alteration. You have the right to ask for a copy of the information we hold about you and to have any inaccuracies in your information corrected. If you have any questions about data protection or require further information, please email dpo@rcoa.ac.uk I have read and understand the College's data protection statement CAPTCHA This question is for testing whether or not you are a human visitor and to prevent automated spam submissions.
