Workforce, training and education
East Midlands

Form R Part B (self-declaration form)

Doctors in training are required to have a completed and up-to-date Form R Part B (self-declaration form) for every ARCP. This applies to both trainees who are in-programme, and to those Out of Programme (although consideration will be given to those on career breaks). East Midlands’ local policy is that Form R Part Bs are valid for 6 months from the date the form is signed.

The HEE East Midlands Assessments & Revalidation Team will email all trainees who are to be assessed ahead of each ARCP, either informing you that your current submission has expired and you must submit a new form, or that your current submission will be valid on the date of your ARCP.

However, you are obligated to submit an updated form if any of the previously provided information has changed, including (but not limited to) Significant Events, sick leave, or you have undertaken any locum shifts since your last ARCP. If you have not had an ARCP in your current specialty, you only need to complete your Whole Scope of Practice and Time Out of Training since starting on your current training programme.

Once you have submitted your form to the team (, you will receive an email within 1-2 working days confirming receipt (during peak times this may be longer, between 4-5 days). If you do not receive confirmation that your form has been received and will be processed, please contact the Coordinator for your specialty using the details in their email signature.


In the Downloads section of the page, you will find a copy of the new Form R Part B (which you can download and complete), as well as some guidance about completing the form (and changes from previous versions of the form).