Freelancer's Enrolment Form

This information is confidential, except for supply in abridged form to prospective clients. The Writers Bureau compiles database entries based on these forms, so please try to be concise.

Please print this form via screen grab or other download (use your browser's print icon or press 'ctrl+P').  Then complete in BLOCK CAPITALS and fax or mail back to us for the record.

Personal details

Title:......... Forename:.................................. Family name:........................................................
Address: ..................................................... Telephone:..........................................................
.................................................................... Fax line:..............................................................
.................................................................... Modem line:.........................................................
.................................................................... E-mail address:....................................................
Own transport? Y/N..................................... Mobile number:....................................................

Professional qualifications

First degree: .............................................. Second degree(s):................................................
................................................................................................................................................
Other professional qualifications. ...........................................................................................
...................................................................................................................................................
Languages (indicate spoken or written and level of competence)
...................................................................................................................................................

Work experience / preferences / rates

How many years have you been writing or practising your present skills?: ....................yrs.
How many agencies (if any) have you worked for in this time?: ..................agencies.
Would you work on-site for a client? Y / N ................. For an agency? Y / N .........

What are your main skills? (please circle a maximum of five and write a number alongside to rank them in order of current relevance / work preference)

 

Medical Writer ........... Scientific Writer ........... Medical Editor ........... Scientific Editor ...........
Production Editor ............ Proof Reader ........... Medical PR ............... Lay PR .......................
Nursing ...................... Other Healthcare .......... Client Manager .......... Multimedia Scripts .......
Physician ............... Database Developer .......... Video Scripting .......... Regulatory Work ........
Pharmacist .................. Other Publishing ........... Other ............
 

If you circled an “Other..” category, please provide details:.........................................................

...................................................................................................................................................

Please indicate your required hourly/daily rate (or other pricing structure) for any kinds of work you would accept:

  • Type of work...(insert rate)....
  • Manuscript writing from trial reports etc. ...................
  • Manuscript editing / styling / consistency check ...................
  • Proof-reading / error checking ...................
  • Abstract writing from report or data ...................
  • Editing proceedings ...................
  • Presentation development (slides / notes) ...................
  • Presentation scripting ...................
  • Writing medical PR articles ...................
  • Writing lay PR material ...................
  • Regulatory writing ...................
  • Writing patient-oriented material ...................
  • Meetings reportage ...................
  • Production editing / laying to page ...................
  • Faculty management ...................
  • Meetings management ...................
  • Video / multimedia production / scripting ...................
  • Other (please specify).................................................
    .............................................................................................................
    .............................................................................................................

    Product / therapy area experience

    Note: We need to know your real areas of expertise. Many people can deal with multiple product / therapeutic areas, depending on the kind of work and depth of familiarity required. We are happy to offer you work outside your current areas of expertise to enable you to learn and to provide some variety. Occasionally, however, clients may specify a high level of credibility and expertise and we need to know where your genuine strengths lie. For non-writers this section is less critical but still relevant.

    Please rank a maximum of ten of these product or therapeutic areas in order of expertise (1= most familiar, 10 = competent but not necessarily expert). If you truly feel you are expert in more than ten, please provide details and a rationale separately. Categories are loosely based on MIMS classifications and there is some overlap / ambiguity. If you are unsure please, again, provide your version on a separate sheet.

    Gastro-intestinal ............... Cardiovascular .................. CNS/ Psychiatry ..................
    Pain / anaesthetics.............. Musculo-skeletal .............. CNS/ Neurology ..................
    Endocrine........................ ..Diabetes........................... Allergy / immunology .................
    Anti-bacterials.................. .Anti-virals......................... Antifungals ...............
    Obst. & Gynae.................. Genito-urinary .................. Dermatologicals...............
    Ophthalmologicals...............Respiratory ..................... Contraceptives .................
    Radiology/con.media ..........Oncology ........................ AIDS...............
    Haematology ..................... Other ..............

    Writing and communications software

    Please indicate which packages you use..............................................................................
    ...............................................................................................................................................

     

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