If you are only looking to withdraw an existing post or supervisor, please email postaccreditation@acrrm.org.au with the following details:

  • Name of post to be withdrawn, or
  • Name of supervisor to be withdrawn/Name of post where currently supervising

This form is to be used by ACRRM accredited Training Organisations for making a recommendation for a:

  • New post accreditation
  • Existing post re-accreditation
  • New supervisor accreditation
Name of RTO / training region:
Type of recommendation:
Level of post accreditation:
Type of post:
Address of post:
State
Contact person at post:
Associated hospital:

Where the post is a GP or AMS and the registrar also works in the local hospital, please enter the following details.

Who delivers services in this hospital?
Additional registrar information:
Which procedural skills could a registrar maintain at this hospital:
Associated facility:

List any other associated facilities (eg branch practices) where registrars will be working.

Address of facility:
State
Will an ACRRM accredited supervisor be working at the facility with the registrar?
Additional supervisor 1 
Additional supervisor 2
Additional supervisor 3
Withdrawn supervisors
New supervisors
Principal supervisor
Fellowship held:
Supervisor has 5 years or more rural experience
Is supervisor accredited to supervise RACGP registrars?
If Principal Supervisor is FACRRM with less than 5 years’ experience or non-FACRRM with less than 5 years’ rural experience, please indicate what support will be available for the supervisor / registrars, refer to Standard 1.1.9
Additional supervisor 1
Fellowship held
Additional supervisor 1 has 5 or more years rural experience
Additional supervisor 1 is accredited to supervise RACGP registrars
Additional supervisor 2
Select a choice
Additional supervisor 2 has 5 or more years rural experience
Additional supervisor 2 is accredited to supervise RACGP registrars
Additional supervisor 3
Fellowship held - Additional supervisor 3
Additional supervisor 3 has 5 or more years rural experience:
Additional supervisor 3 is accredited to supervise RACGP registrars
A total of four supervisors can be added on this form. If you have more than four, please use a new form for the remainder.

Please provide any additional comments

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