You must complete and submit this form to claim the third payment of the Panel Development Incentive. Before completing this form, please ensure that you have submitted Claim Form #1 and Claim Form #2 of the Panel Development Incentive. This form cannot be submitted before you have submitted Claim Form #1 and Claim Form #2. If you have any questions or problems regarding the completion of this form or about the Panel Development Incentive, please email panel.incentive@doctorsofbc.ca.
The GPSC collects and uses information to support: education; mentoring and quality improvement training; practice supports; ongoing learning and capacity building; development of new programs, services and resources; and evaluation and reporting purposes. Information received is owned and stored at Doctors of BC with access limited to authorized Doctors of BC staff. Under BC privacy legislation, GPSC members, Ministry of Health staff/official and Health Authority staff do not have access to individual or identifiable data except with the explicit consent of the participating physician. Without such consent, they only have access to aggregate evaluation and quality improvement reports prepared by authorized Doctors of BC staff. The GPSC is subject to and complies with the BC Personal Information Protection Act. For more information, contact privacyofficer@doctorsofbc.ca.
Have you submitted Panel Development Incentive Claim Form #1 and Claim Form #2?
To be eligible for this incentive payment, you must first complete and submit Claim Form #1 and Claim Form #2 of the Panel Development Incentive.
I hereby certify that the information provided on this application is truthful and accurate and that I understand and meet all of the eligibility requirements of the Panel Development Incentive as outlined in this Panel Development Incentive Claim Form.
I understand that if I am compensated by a sessional, service, or salary contract for work specifically covered by the Panel Development Incentive, I am not eligible for the Panel Development Incentive.
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