Practising Privileges Application

Thank you for your interest in practising at Deansgate Hospital, Manchester. To apply for practising privileges, please review the documents below, then complete the application form and upload your supporting documents. Your application is stored securely and reviewed by the Clinic Director and Medical Advisory Committee. Applications cannot be progressed until all required documentation is received.

Step 1 — Review and download:

• CLNQ Practicing Privileges 1.4— please read, sign the agreement page, and upload your signed copy below
• Application Form (Word) — for reference, or complete offline and upload instead of filling in the online form

Step 2 — Complete the form below and upload your documents. Files accepted: PDF, Word, JPG, PNG (max 10MB each).