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HSMP Assessment Form (For Less than 28 Years Age) Main Page

Click Here if you are 28 or over

Your Age (Maximum 5 points for under 28 Year Age)

If you are under 28 years of age you will gain 5 additional points and it will be easier for you to come under HSMP.*

Click Here if You are 28 or over

About You

Title *

First name *

Last name *

Date of birth *

Nationality *

Gender *

Male Female

Marital status *

Single
Permanent relationship
Married
Other

Number of Children *

Amount you have available to take with you to the UK *

If relevant, status in the UK

If relevant, will you be relocating together with your immediate family?

Yes No

Address and contact details

Street Address

Town/City

Post Code/Zip Code

Country

E-Mail*

Telephone*

Mobile / Cell phone

Education

Academic qualifications*

Bachelors Degree - 15 points
Masters Degree - 25 points
Doctorate - 30 points
Vocational or Professional Qualifications - see below
Not Applicable

Please provide full details if you have selected "Vocational or Professional Qualifications"

College/University Attended Year of graduation

Work Experience*

2 years graduate level work experience - 25 points
4 years graduate level work experience - 35 points
4 years work experience in a graduate level job including senior or specialist level work experience for one year - 50 points
Not Applicable

If claiming points for senior or specialist level work experience

Job title Brief job description

Earnings in the last twelve months in your country of residence

You may wish to go to the Universal currency convertor to convert to UK currency

Income over last twelve months in UK Currency*

Primary Country of residence over last twelve months*

Achievement in your chosen field

Please confirm one of the following (if relevant)

Not Applicable
I claim 15 points for significant achievement
I claim 25 points for exceptional achievement

Please tick below the documentation you can provide to demonstrate either significant achievement or exceptional achievement

Industry Prize
Published Work
Peer group reviews
Academic References
Industry Reference
Ownership of intellectual property rights
Published testimonials/profile
Scholarship/research awards
Press Articles
Other

Please provide further details

Please provide further details of documentation you can provide (three different types) and details of why you feel you can come under significant achievement or exceptional achievement

HSMP Priority Application

Currently limited to doctors who can work as general practitioners in the UK.

You have full GMC (General Medical Council) Registration?

Yes No

A vocational training certificate issued by the UK or another EEA member state. This would have to be validated by the General Medical Council.
A certificate of acquired right issued by the UK or another EEA member State. This would have to be validated by the General Medical Council.
A certificate of equivalent experience issued by the Joint Committee on Postgraduate Training for General Practice.
None of above

Spouse's or Partner's Achievements* (Maximum 10 points)

You can gain points under this category if you have been living together with your spouse or partner for at least two years who has a bachelors degree, or equivalent vocational or professional qualifications, or has experience in a graduate level job.

Bachelors degree or higher, or equivalent vocational or professional qualifications - 10 points

Graduate level work experience - 10 points

Not Applicable - 0 points

Other Requirements

Please rate your English language abilities*

1 2 3 4 5

(a scale of one to five (1-5), five standing for complete fluency, one standing for no English language ability at all)

Do you intend to make the UK your main home*

Yes No

(Please note that this is a requirement of this programme)

If relevant, do you have the necessary qualifications and membership of the relevant organisation to work in the UK in your chosen field?

Yes No

Are there any restrictions on your ability to work in the UK for one reason or another?*

Yes No

If Yes, please provide further details:

Please explain why you feel confident of finding suitable work in the UK or provide details of an employer or agency interested in your services in the UK:*

How much do you expect to earn during your first twelve months in the UK?*

You may wish to go to the Universal currency convertor to convert to UK currency.

Amount in GBP:*

Have you ever been or are currently bankrupt?*

Yes No

If Yes, please provide further details:

Have you ever been convicted of any criminal or civil offence?*

Yes No

If Yes, please provide further details:

If possible, please copy and paste your work experience and qualifications details here without formatting commands:*

Please provide details of graduate level work experience and qualifications for your spouse or partner:*

partner only if you have been together 2 years

Additional information

How did you hear of capital-consultant.com?

Comments :

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