Locum GP Controlled Drugs Self-Assessment and Declaration Form

Closed 30 Jun 2023

Opened 15 Mar 2021


DoH  Accountable Officer  (AO) has a legal responsibility to seek assurance that all CDs are managed appropriately across primary care, including by individual GPs. Please complete the CD Self-Assessment and Declaration below.

Refer to the cover letter for further background to this self-assessment and declaration, and supporting information including Frequently Asked Questions (FAQs), which may be helpful in completing this form. Appendix 1 of the letter shows common examples of CDs in each Schedule (S).

Note:  No patient/carer identifiable information should be included in the responses.

  • Complete Section A Only: if you currently work as a GP Locum in Northern Ireland
  • Complete Section B Only: if you no longer work as a GP Locum in Northern Ireland


  • Health professionals


  • Provision of health and social care services