Jessica McLaren

The Department of Health maintains all licensing for all medical services. The Medical Board shall be resposible for the issuance of licenses which is an independent body within the Department of Health. Please review the information contained in this section before proceeding.

Moderators: Executive Officers, DOH: State Medical Board

Post Reply
Jessica_McLaren
Posts: 11
Joined: July 25th, 2018, 8:43 am

Jessica McLaren

Post by Jessica_McLaren » June 30th, 2019, 10:52 am


Image

STATE OF SAN ANDREAS
REQUEST FOR MEDICAL RECIPROCITY


  • SECTION ONE - PERSONAL INFORMATION

  • 1. TITLE: Miss
    2. FULL NAME: Jessica McLaren

    3. DATE OF BIRTH: 6/MAY/2001
    4. PLACE OF BIRTH: UK, London.
    5. AGE AT TIME OF APPLICATION: 18

    6. PHONE NUMBER: 1-7-4-0-5-59
    7. E-MAIL ADDRESS: [email protected]
    8. DOMESTIC ADDRESS: 1768 Alexandria Avenue, East Los Santos, Los Santos 424, San Andreas

  • SECTION TWO - PERSONAL HISTORY

  • 9. HAVE YOU EVER GONE BY ANOTHER NAME? IF YES, LIST ALL THAT ARE APPLICABLE BELOW:
    1. No, I did not do that.
    10. HAVE YOU EVER BEEN CONVICTED OF BREACHING ANY OF THE SAN ANDREAS LAW OR THAT OF ANOTHER COUNTRY?: IF YES, EXPLAIN IN THOROUGH DETAIL:
    1. I haven't been committed any crime.
    11. LIST ALL AND ANY EDUCATION THAT YOU HAVE ENROLLED IN. ADD MORE FIELDS IF NEEDED:
    • NAME OF HIGH SCHOOL: Newham College
      YEAR GRADUATED: 2018
      DEGREE(S) EARNED: High School Diploma

      NAME OF COLLEGE: N/A
      YEAR GRADUATED: N/A
      DEGREE(S) EARNED: N/A

      NAME OF MEDICAL SCHOOL: N/A
      YEAR GRADUATED: N/A

      TYPE OF MEDICAL DOCTOR: DOCTOR OF OSTEOPATHIC MEDICINE (D.O.) / MEDICAL DOCTOR (M.D.)
      MCAT SCORE (COMPLEX-USA SCORE IF D.O):
      RESIDENCY LOCATION:
      SPECIALIZATION:
      AFFILIATIONS AND OR BOARD CERTIFICATIONS:

      12. LIST ALL AND ANY PREVIOUS EMPLOYMENT. ADD MORE FIELDS IF NEEDED:
      • NAME OF EMPLOYER: Dave Watson
        PLACE OF EMPLOYMENT: ROZE Entertainment and Events
        OFFICIAL COMPANY TITLE: ROZE Entertainment and Events
        JOB DESCRIPTION: Being a general assistant. Making events for different people.
        DATE EMPLOYED: 29/06/2019
        DATE DISCHARGED: N/A
        REASON OF DISCHARGE: N/A

    • SECTION THREE - LICENSING BASED QUESTIONS

    • 13. WHAT SORT OF PRACTICE/PROFESSION ARE YOU AIMING TO PURSUE IF LICENSED?:
      • [ ] NURSING
        [X] DOCTOR
      14. HAVE YOU EVER BEEN TRAINED IN BASIC LIFE SUPPORT AND/OR INTERMEDIATE LIFE SUPPORT?:
      • [ X YES (WHO WAS THIS PROVIDED BY?: While I was in France, I took some courses and learned about BLS and First Aid Kit and about resuscitation.)
        [ ] NO
      15. PLEASE EXPLAIN IN FURTHER DETAIL WHY YOU WISH TO ACQUIRE A LICENSE TO PRACTICE MEDICINE:
      • I wish to have this license so that I can practice legally medicine, so I will be able to help people, knowing different things that normal people usually don't know, so I can be more helpful to this community. People are important for other people, I know that and I have to help all the people that get hurt to stop dying because I'm there and I can help 'em.

    • SECTION FOUR - DECLARATION

    • I, Jessica McLaren, hereby declare that all of the information stated within this application is true and is as accurate to my knowledge as possible. I accept that, should I be found to have lied regarding any information, I am subject to immediate disciplinary action without question. I also affirm that I understand that, should my license be accepted, I am required to learn and follow acts up to and regarding the Hippocratic Oath. This declaration also serves as a confirmation that I have filled in all aforementioned details on my own and not by another.
      DATE: 30/JUN/2019
      SIGNATURE: ANSWER

Post Reply