Graduate Registered Nurse and Midwife – Referee Report Page 3 of 3
Thank you for your time and valued response
Information for referees
1. Nursing and midwifery graduate applicants are responsible for bringing completed referee reports to their interview.
2. Referee reports must be returned directly to the nursing or midwifery graduate applicant.
3. Referee reports must be hand signed by the referee or include an electronic signature (not name written in italics or fancy
4. Referees must meet one of the following criteria:
a. Nursing/Midwifery Clinical Facilitator from the applicant’s final year of study or Nurse Unit Manager/Preceptor who has
been directly responsible for the applicant’s clinical placement supervision for two (2) weeks or more full time (or a
minimum of 80 hours placement) and has direct knowledge of clinical performance;
b. Current Line Manager (or previous line Manager from within the last two (2) years, if not currently employed) who has a
direct supervisory role. This does not need to be a nursing/midwifery position;
c. Supervisor for a volunteer position e.g. St John’s Ambulance, Red Cross, sports coaching. The referee must be a direct
supervisor of the applicant.
5. Referee reports which are returned to the applicant via email must be forwarded from the referee’s work email account, not a
personal email account.
Emails must include the declaration outlined below:
I, <insert name> have completed this referee report and returned it via email to the nursing/midwifery graduate applicant
whose name appears on the top of this referee report. This report includes my signature and is a true and accurate reflection
of my knowledge of the applicant. The applicant is requested to bring the referee report and this email to their interview.
6. Emailed referee reports must be forwarded to the applicant in PDF format.
7. Referee reports are not to be forwarded directly to Queensland Health facilities.
8. Referee reports are valid for 12 months from date of signature.
9. Referees who do not wish referee reports to be viewed by the applicant prior to review by the interview panel, should
indicate by ticking the box below and placing the report in a sealed envelope. Please sign across the envelope seal to identify
envelope has been sealed by the referee. These reports must be returned directly to the applicant to bring to their interview.
Sealed referee report provided to applicant
Are you aware of any poor
performance issues, formal
complaints, disciplinary or
legal action against the
If so, what were the issues
and what was the outcome?