Health improvement practitioner (HIP) trainer nominations

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HIP trainer nomination form

HIP trainer candidate eligibility

To be eligible to become a HIP trainer candidate, nominees are required to:

have at least six months experience practicing as an endorsed HIP
hold a current registration and annual practicing certificate
be employment in an IPMHA position (at least 0.5 FTE).

Nomination

Trainer candidates are nominated by their employer or regional spoke lead organisation. This reflects confidence in the candidate’s potential to become a trainer and strengthen the HIP workforce.

The nomination includes

A statement of support from the employer or regional spoke lead organisation, outlining:

how the nominee aligns with the values and goals of the HIP model
their capability and potential to support others’ learning and development
the organisation’s commitment to releasing and supporting the nominee to complete the training pathway

An application from the nominee, which includes:

a written application describing their experience, strengths, and readiness for the trainer role. Before writing this, nominees complete the Keeping it Real | Kia Pono te Tika self-assessment at the leadership level to help reflect on their practice.
a self-assessment of the HIP trainer core competencies, highlighting current strengths and areas for further growth.

To submit a nomination, the employer or line manager completes the nomination form below.

Meets eligibility criteria:

six months experience practicing as an endorsed HIP

current registration and annual practicing certificate

currently employment in an IPMHA position (at least 0.5 FTE)

Name of person nominating HIP

Email of person nominating HIP

Nominee first name

Nominee last name

Nominee email

Nominee contact number

Nominee's Organisation

Nominee's organisation's email address

Employer's first name

Employer's last name

Employer's phone

Employer's email

Nominee's role

Nominee's FTE

If full-time, put 1.0. If less than full time, please put their FTE.

Demographics of enrolled patients

Please provide a breakdown of demographics for the primary care clinic. For example, ethnicity and youth percentage.

Registration body

APC number

Upload statement of support from the employer or regional spoke lead organisation

Attachment

Upload nominee written application

Attachment 2

Download, complete and upload self-assessment of HIP trainer core competencies

Please download the HIP trainer core competencies (add link), complete and upload.

Attachment 3

Submit nomination

Click the button below to submit your nomination. If your submission is successful, you will be taken to a confirmation page and receive a confirmation email. If you don't receive a confirmation email, your submission was not successful.