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  • Reference Request Drs

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    Talha Latif
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    This document is a reference request form completed by Dr. Sohail Farooq for Musab Bin Umair, who worked as a medical officer from October 2019 to October 2020 at Ali Ahmad Khan Hospital, where Dr. Farooq rates Bin Umair's clinical and interpersonal skills as meeting expectations and says he would re-employ him, describing him as an energetic young doctor with good clinical abilities.

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    This document is a reference request form completed by Dr. Sohail Farooq for Musab Bin Umair, who worked as a medical officer from October 2019 to October 2020 at Ali Ahmad Khan Hospital, where Dr. Farooq rates Bin Umair's clinical and interpersonal skills as meeting expectations and says he would re-employ him, describing him as an energetic young doctor with good clinical abilities.

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    © All Rights Reserved
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    17 views1 page

    Reference Request Drs

    Uploaded by

    Talha Latif
    This document is a reference request form completed by Dr. Sohail Farooq for Musab Bin Umair, who worked as a medical officer from October 2019 to October 2020 at Ali Ahmad Khan Hospital, where Dr. Farooq rates Bin Umair's clinical and interpersonal skills as meeting expectations and says he would re-employ him, describing him as an energetic young doctor with good clinical abilities.

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    of 1

    Urgent - Reference Request FAX NUMBER 01277 246 850

    Contact Details to return references


    Dr. Sohail Farooq
    Referee Name:
    Email: compliance@promedical.co.uk
    Position of referee: Consultant Physician Please make sure that this is not sent from a
    private email account.
    Hospital: Ali Ahmad Khan Hospital
    Fax: 01277 246 850
    Date Requested: 16-04-2021 Fax/ Email: drsohailfarooq@yahoo.com

    Post: ProMedical, The Granary, 4-6 Crescent


    Applicant’s Name: Musab Bin Umair
    Road, Brentwood, Essex, CM14 5JR
    GMC Number: 76300 Grade/ Spec: Medical Officer
    All written references need to be on headed
    paper addressed to ProMedical, signed &
    Employment Dates: Start: OCT-2019 End: OCT-2020
    include dates of employment.
    By signing this reference you will be agreeing to the above dates of employment
    if these are incorrect please state here: Start End

    Compliance Officer:

    Please tick below in regards to the applicant:

    Clinical Skills Exceeds expectations ✔ Meets Expectations Below Expectations

    History Taking/ Administration Exceeds expectations ✔ Meets Expectations Below Expectations

    Physical Examination Exceeds expectations ✔ Meets Expectations Below Expectations

    Investigation & Diagnosis Exceeds expectations ✔ Meets Expectations Below Expectations

    Judgment & Patient Management Exceeds expectations ✔ Meets Expectations Below Expectations

    Reliability/ Punctuality Exceeds expectations ✔ Meets Expectations Below Expectations

    Relation with Colleagues Exceeds expectations ✔ Meets Expectations Below Expectations

    Relation with Patients Exceeds expectations ✔ Meets Expectations Below Expectations

    Appearance Exceeds expectations ✔ Meets Expectations Below Expectations

    Communication Skills – Written Exceeds expectations ✔ Meets Expectations Below Expectations

    Below Expectations
    Communication Skills – Verbal Exceeds expectations ✔ Meets Expectations

    Would you re-employ this candidate? ✔ Yes No

    Additional Comments: Musab Bin Umair did a very good job with me at Ali Ahmad Khan Hospital. He is an energetic
    young doctor with very good clinical skills.

    By signing this reference you agree for it to be passed onto a 3rd party such as an NHS Trust for employment and audit purposes and agree to the
    dates of employment as stated above.

    Print Full Name: Dr. Sohail Farooq GMC No:

    Grade: Speciality: Internal Medicine


    Consultant
    Signature/PP
    And Hospital Date Signed: 19-04-21
    Stamp:

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