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Work experience request form

***Please note we are now fully booked in all clinical areas in 2019 so will only be accepting applications for 2020. Please check the online tracker to ensure the dates you are requesting are free.***

Before completing the form please ensure you check the dates you are requesting are available by looking at our online tracker and ensure you fit into the age restrictions outlined below:

  • To complete a placement within maternity you must be aged between 16-18
  • To complete a placement within theatres you must be 18 and over (if 16-17 you can spend a half day placement in the recovery area of theatres)

Please be aware, we are currently experiencing a high demand for work experience placements therefore you may not receive a response straight away. If you have submitted an application you will hear back from us within approximately 4 weeks. Thank you

Your Details
Next of Kin
School/College Information
Additional Information
Requested Dates for Work Experience Placement
(Years 10/11 - placements are usually one week only, it may be possible to arrange two weeks in certain areas)
Please briefly explain why you have chosen this placement and what you hope to get from it. Include your hobbies and interests and your plans for the future.