Useful Forms

There are a number of forms and protocols that are relevant to different aspects of the course - these can be found within the relevant tab

Clinical Placement - Supervisor & trainee feedback forms

Portfolio of Clinical Experience and Cumulative Training Records

Forms: Trainee Research

Here are some forms related to the Major Research Project. For guidance on which ones to use and how to complete them, please consult the relevant course document, e.g. the Research Governance Checklist. Note that some forms cannot be listed here, either because they need to be completed online on a separate website, or because there's no electronic version available.

Getting started

Statement of Intent Form

Data Protection Form, UCL

Risk Assessment Form

Proposal for Research Expenses

Subject Payment Form

Progress review forms

Research Progress Review Form, Year 2 Term 2

Research Progress Review Form, Year 2 Term 3

Research Progress Review Form, Year 3 Term 2

Research Supervisor Appraisal Form

Prior to submission

Title and Abstract Form

Thesis Declaration Form

Thesis Submission Extensions Form

Thesis Submission Deferrals Form

Developmental Reviews

Client Consent Forms

Case Reports - Supervisor Confirmation of Case report Details

Annual Leave Monitoring

Intake 2013/Intake 14

Please use the below as appropriate:

Annual Leave Form 2014-15

Annual Leave Form 2015-16

Annual Leave Form 2016-17

Annual Leave Form 2017-18

Intake 2015

Please use the below form for recording your AL:

Annual Leave Form - Intake 2015

Intake 2016

Please use the below form for recording your AL. Please see the example form for guidance on how this should be completed:

Annual Leave Form - Intake 2016

Annual Leave Form - Intake 2016 Example Form


Forms for Members of Staff

Maternity Leave (Keeping in Touch/KIT days)

Extenuating Circumstances


Any circumstances likely to affect examination performance should be notified in writing, with appropriate supporting documentation, and submitted no later than one week after the end of the examination period in question. These circumstances will be considered in strict confidence.

Circumstances which have already been brought to the attention of the Board of Examiners and for which allowance has already been made (eg extra time allowed because of dyslexia, extension of deadline for coursework) should not be notified in this way. The examiners will be aware of these circumstances, but any circumstances which might affect examination performance can be taken into account only once for each diet of examinations.

Please complete the form below and submit to Tony Roth. Trainees should retain a copy of all documentation.

Request to Defer Case Report Submission

This form is used to request an extension of longer than one week on the grounds that a practical problem has arisen on placement that means that there is a predictable delay in gathering the clinical material for the report. Examples would be:

· where the plan is to submit a ‘completed treatment’ report but the patient fails to attend the final session because of physical illness; a further appointment has been arranged but this will not take place until after the submission deadline.

· where completion of multi-disciplinary assessment is delayed because the final assessment has been unexpectedly postponed by a senior colleague; a new date has been scheduled, but this will not take place until after the submission date.