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Brockville General Hospital requires the BGH Electives Application Form (Application for Clinical Training) be completed by all Medical trainees at least 4 weeks before their clinical experience commences.  All application forms are to be accompanied with a recent photo and proof of immunization (Note: proof of TB test within the past year is needed).  The Brockville General Hospital requires that each student meets all of the requirements as summarized here - Communicable Disease Screening Requirements.

Failure to submit a completed Electives Application form along with all supporting documentation at least 4 weeks in advance of the proposed rotation start date will result in Brockville General Hospital cancelling your rotation.

Please return completed Electives Application Form and all supporting documentation by email to by fax 613-345-8305.
If you have any questions regarding the form please contact:

Katie Stone
Education Assistant
Telephone:  613-345-5649 ext 1221
Fax:  613-345-8336