SCHEDULE 3
Part IIIInformation and undertakings to be provided by the existing partners in relation to an application to practise in partnership
2
Particulars of each existing partner who will form part of proposed new partnership, including—
a
name and cypher number;
b
whether practising as—
i
a full-time doctor;
ii
a three-quarter-time doctor;
iii
a half-time doctor; or
iv
a job-sharing doctor;
c
age;
d
number of persons on list;
e
proposed partnership shares, dates and exclusions (if any)—
i
commencing;
ii
first share change;
iii
second share change; and
iv
third share change;
f
time spent on other health service appointments or health service administration, including—
i
number of sessions;
ii
type of appointment; and
iii
average weekly hours; and
g
time spent on regular non-health service appointments (eg Medical Referee, Police Surgeon, Occupational Medicine etc), including—
i
type of appointment; and
ii
average weekly hours.