Temporary Staff Registration Form

Thank you for expressing an interest in supporting University Hospitals Coventry & Warwickshire NHS Trust with the increased pressures during the coronavirus outbreak.  To best utilise your skills and allocate appropriate tasks, please can you complete the following questions:

Following the release of Government guidance, we are unable to facilitate placements for people who are considered 'extremely vulnerable'. The definition of this group of people can be found:

The Government has also identified a group of 'vulnerable' people who are advised to socially isolate. The definition of this group of people can be found:

If you have one of the conditions, we will need to understand more about this and undertake a risk assessment with you to facilitate the most appropriate placement.

Please complete for an organisation
Paid Workers Do you have a current registration Preferred Speciality Days able to work Any restrictions on shift patterns (eg. Not able to work nights Number of People Available Number of hours available to work per day
Medical Doctors
Allied Health Professionals
Healthcare Support Worker
Admin & Clerical