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Jigsaw Medical
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Jigsaw Medical
Clinical Services Clinical Services

Ambulance & Clinical Services

Advancing clinical care in the pre-hospital setting.
Event Medical Event Medical

Event Medical Cover

First aid and medical cover for events uk wide
Training Training

Training & Education

First aid training and clinical education.
Special Projects Special Projects

Special Projects

Solutions for the hostile, remote and security industries

General Enquiries: 01829 732 615
Transport Bookings: 0330 311 9999

Reference Request

Dear Sir/Madam,

has recently applied for a position as a . They have supplied your name as a person who would be prepared to supply us with a reference. As such, it would be appreciated if you could complete the form below at your earliest convenience. Alternatively, you are welcome to upload a document containing this information.

Should you require any further assistance then please do not hesitate to contact our compliance team on 01829 732615 selecting option 4

Upload a reference

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fill in the form below

Please note all fields are required

About you

Candidate Background

Candidate Suitability

Please give your opinion on the candidates suitability for the post by choosing the appropriate option:



Relationship with others


Ability to organise and prioritise Work

Communication – Written

Communication – Verbal

Sickness record (over the last 2 years)


Please note that applicants are exempt from the provisions of the Rehabilitation of Offenders Act. Please complete the following:

Further Information

Would you re-employ the candidate in their current/most recent position?

Has this candidate been the subject of a disciplinary hearing, either resolved or unresolved whilst employed by you?

Did the candidate leave voluntarily?