Consent I confirm
Please select below if you do/do not agree for your personal data to be made available to any 3rd party without direct supervision from a member of staff from TLA or myself being present.
  • I do
I confirm that I give my permission to The Locum Agency to share my data with Total Assist RecruitmentI do
DepartmentTLA
NameLi Chan
Professional Registration NumberN/A
Date of Birth03/01/1993
Signature (Locum)
Locum signature Date05/12/2023
Signature (TLA)
TLA signature Date05/12/2023