Reflect and Rejuvenate application

Your name

Your email

Your GMC registration number

When did you qualify as a GP?

Your Practice name

Practice rural/urban classification

Please refer to the explanation at the foot of this page

Practice website address

Briefly describe your Practice and Practice population

Your role with the Practice

How long have you been a GP with the practice?

What is your particular area or areas of clinical interest?

What particular things do you want to experience by working in a different Practice?

Let us know if you have identified a Practice you would like to visit

	Scottish Government 8 fold Urban Rural Classification
1 Large Urban Areas	Settlements of 125,000 or more people.
2 Other Urban Areas	Settlements of 10,000 to 124,999 people.
3 Accessible small Towns	Settlements of 3,000 and 9,999 people and within 30 minutes drive of a settlement of 10,000 or more.
4 Remote Small Towns	Settlements of between 3,000 and 9,999 people and with a drive time of over 30 minutes to a settlement of 10,000 or more.
5 Very Remote Small Towns	Settlements of 3,000 and 9,999 people and with a drive time of over 60 minutes to a settlement of 10,000 or more.
6 Accessible Rural	Areas with a population of less than 3,000 people, and within a 30 minute drive time of a settlement of 10,000 or more.
7 Remote Rural	Areas with a population of less than 3,000 people, and with a drive time of over 30 minutes but less than 60 minutes to a settlement of 10,000 or more.
8 Very Remote Rural	Areas with a population of less than 3,000 people, and with a drive time of over 60 minutes to a settlement of 10,000 or more.