Anaesthesia Associates Registration Form

The General Medical Council (GMC) will begin regulation of anaesthesia associates on 13 December 2024. Once regulation begins, the AA register will then sit with the GMC and ahead of this, the College would like to share with them certain data we hold. In order to comply with GDPR Regulations, we wish to seek explicit consent from you before sharing this information.

Please therefore confirm the following information to join the AA Managed Voluntary Register, and advise if you consent, or not, to it being shared with the GMC.

Please note this form is applicable to qualified anaesthesia associates only.

College Reference Number (CRN)

Title

First Name

Other names (if applicable)

Last Name

If you have changed your name since qualifying, please advise of your previous name held at the time of qualification so we can confirm with the university (this will not be shared with the GMC)

Date of Birth (DD/MM/YYYY)

Mobile

Please note the RCoA will need to contact your awarding body/university to verify your qualification details. If you do not wish for us to contact your university to share this information, please leave the following qualification questions blank.

Qualification awarding body

Primary/first Qualification type: (this must be your first qualification and does not include top ups to Masters)

Qualification pass date (DD/MM/YYYY)

Employing hospital name and address (this will not be shared with the GMC)

Signature

Please sign above using your mouse or finger (if using a touchscreen device).

Date

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

Math question 11 + 0 =

Solve this simple math problem and enter the result. E.g. for 1+3, enter 4.

This question is for testing whether or not you are a human visitor and to prevent automated spam submissions.