Please use the form below to apply to become a BMS Menopause Trainer.

Fields marked with an asterisk (*) are compulsory.

    1. Your details

    Your first name (as it appears on the GMC/NMC register):*

    Your surname (as it appears on the GMC/NMC register):*

    Your GMC/NMC Number:*

    Your BMS Membership Number:*

    Are you under any restrictions to practice?*
    yesno

    If yes, please provide information:

    Job title:*

    Place of work:*

    Telephone number:*

    Preferred email address:*

    Other email address:

    In which of the following places will you be undertaking training:*
    General PracticeCommunity clinicNHS hospitalPrivate practice

    2. Which of the following best describes your professional background?*
    DoctorNurse (independent prescriber)

    Please confirm you have active Trust Indemnity / Medico-Legal Indemnity that covers your practice:*
    yesno

    Please provide further information if necessary:

    3. Are you a BMS Menopause Specialist?*
    yesno

    4. Please confirm that you are actively involved in teaching and assessment:*
    yesno

    Please describe your involvement in teaching and assessment:*

    5. Have you attended a ‘Training the Trainers’ course or equivalent?:*
    yesno

    Date carried out:*

    Please provide further information if necessary:

    Please confirm that you are actively involved in training:*
    yesno

    Please describe your involvement in training:*

    Please confirm that your role in training/supervision/teaching is included in your job plan and documented at your annual appraisal:*
    yesno

    6. Are you up to date with CPD and appraisals within your working structure?:*
    yesno

    Please provide date of your last appraisal:*

    7. Please confirm that you are up to date with training in equality and diversity:*
    yesno

    Please provide further information if necessary:

    8. Are you currently an RCOG Menopause ATSM Supervisor / Trainer?*
    yesno

    Are you currently an FSRH Menopause Principal Trainer?*
    yesno

    Are you currently an RCOG Supervisor/Trainer or an FSRH Registered Trainer (other than menopause)?*
    yesno

    Are you currently a GP Trainer?*
    yesno

    9. Please upload a copy of your CV:*
    (max size 2MB; acceptable formats - pdf, doc, docx)

    By using this form you agree with the handling of your data by the British Menopause Society in line with the website's terms of use and privacy policy.

    Note: You will not be able to save a copy of this form prior to submission.  Please read through the form and make sure that you have all the required information available.

    You will be asked to submit a copy of your CV (max size 2MB; acceptable file formats – pdf, doc, docx).

    You will be sent a copy of your completed form by email when it is submitted.