Apply to Provide Locum Services

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Personal information on this form is collected under section 31(c) of the Freedom of Information and Protection of Privacy Act R.S.P.E.I. 1988, c. F-15.01, to evaluate the qualifications of applicants to the Physician Locum Program. If you have any questions about this collection of personal information, you may contact the Recruitment and Retention Secretariat at 902-620-3874 or healthrecruiter@gov.pe.ca.

Identification
For example C1B 0X1 or 12345
For example 902-555-5555