Forms

• Travel Reimbursement Request Form

• Community Rotation Evaluation Form

• Perth & Smiths Falls Hospital Form

• Brockville General Hospital Application for Clinical Training Form

Brockville General Hospital requires the BGH Application for Clinical Training Form be completed by all Medical trainees before their clinical experience commences. All application forms are to be accompanied with a recent photo and proof of immunization. Failure to complete the form will result in Brockville General Hospital cancelling your rotation.

Please complete the form and fax to the attention of Fay Garvin, Executive Administrative office at fax #613-345-8336 as soon as possible.

If you have any questions regarding the form please contact:

Fay Garvin
Executive Assistant
Email: garfa@bgh-on.ca
Telephone: 613-345-5649 ext. 1-1103
Fax: 613-345-8336