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{"sheet":"様式第１号","index":0,"n_rows":23,"n_cols":1,"rows_kept":23,"merged":[[1,0,1,5],[5,0,5,5],[6,0,6,5],[7,0,7,5],[10,0,10,5],[13,0,13,5],[17,0,17,5],[18,0,18,5],[19,0,19,5],[20,0,20,5],[22,0,22,5]]}
["（様式第１号）"]
["令和　　年　　月　　日"]
[]
["広島県健康福祉局医療介護基盤課長　様"]
[]
["住　所　"]
["法人名　"]
["　　　　　　　　　　　　　　　　　　代表者　　　　　　　　　　　　　　　　　　　"]
[]
[]
["女性医師等就労環境整備事業　事業計画申請書"]
[]
[]
["　このことについて、関係資料を添えて、事業計画申請書を提出します。"]
[]
[]
["　〔 添付書類 〕"]
["　　１　女性医師等短時間正規雇用導入支援事業　事業計画書"]
["　　２　ベビーシッター等活用支援事業　事業計画書"]
["　　３　宿直等代替職員活用支援事業　事業計画書"]
["　　４　女性医師等復職研修支援事業　事業計画書"]
[]
["　　注）該当する事業に○をしてください。"]

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["　(様式第２号)"]
["女性医師等短時間正規雇用導入支援事業 事業計画書"]
["医療機関名",null,null,""]
["所在地",null,null,"〒"]
["代表者名",null,null,""]
["担当者の \n所属・氏名",null,null,"(所属)          ",null,"(氏名)"]
["電話番号",{"$nulls":4},"　　FAX番号"]
["E-mailアドレス",null,null,""]
["医師数\n(うち女性医師数)",null,null,"常　勤　　　人　(うち女性医師　　　人) "]
[{"$nulls":3},"非常勤　　　人　(うち女性医師　　　人)"]
["貴院における女性医師等短時間正規雇用制度の内容",null,null,"※ 貴院における制度の内容について、予定案でかまいませんので、記入してください。    "]
[{"$nulls":3},"１　短時間正規雇用の制度の有無 "]
[{"$nulls":3},"　　・ 有"]
[{"$nulls":3},"　　・ 無　 ⇒ 　制度創設の予定時期(令和　　   年　　   月頃) "]
[{"$nulls":3},"２　制度の対象となる職員の範囲"]
[]
[]
[{"$nulls":3},"３　貴院における短時間正規雇用の形態で勤務する医師の数"]
[{"$nulls":3},"　　(　　　　　　)人 "]
[{"$nulls":3},"４　短時間正規雇用の勤務形態の概要"]
[{"$nulls":3},"　　例)・週5日(月～金)9:00～13:00 時間外勤務、当直勤務を免除 等 "]
[]
[]
[]
[{"$nulls":3},"５　短時間正規雇用で勤務する医師の給与支給内容(給与の調整方法、給与額等)"]
[]
[]
[]
["補助金申請を予定し ている短時間正規雇 用により勤務する医 師について"]
[{"$nulls":3},"１ 申請を予定している女性医師等の短時間正規雇用での勤務開始(予定)月"]
[{"$nulls":3},"　令和　　  年　　　 月から"]
[{"$nulls":3},"２ 申請を予定している女性医師等の担当業務(予定)"]
[]
[]
[]
["経費見込み額",null,null,"短時間正規雇用により勤務する女性医師等の人件費(給与費及び法定福利費)"]
[{"$nulls":3},{"$f":"D60","v":{"v":0,"d":"0 "}},null,"円"]
[]
[]
[]
[]
[]
[null,"〔 人件費の見込額の内訳 〕"]
[]
[]
[{"$nulls":6},"(単位：円)",null,"（事業者は入力不要です。）"]
[null,"区　分",null,"給与額及び法定福利費の見込み額",{"$nulls":4},"基準額","選定額"]
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[null,"２月",null,{"v":0,"d":"0 "},null,null,"円",null,{"v":0,"d":"0 "},{"v":0,"d":"0 "}]
[null,"３月",null,{"v":0,"d":"0 "},null,null,"円",null,{"v":0,"d":"0 "},{"v":0,"d":"0 "}]
[null,"合　計",null,{"$f":"SUM(D48:F59)","v":{"v":0,"d":"0 "}},null,null,"円",null,{"$f":"SUM(I48:I59)","v":{"v":0,"d":"0 "}},{"$f":"SUM(J48:J59)","v":{"v":0,"d":"0 "}}]

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[null,"(様式第３号)"]
["ベビーシッター等活用支援事業 事業計画書"]
["医療機関名",null,""]
["所在地",null,"〒"]
["代表者名",null,""]
["担当者の \n所属・氏名",null,"(所属)          ",null,null,"(氏名)"]
["電話番号",null,"　　",null,null,"FAX番号"]
["E-mailアドレス",null,""]
["医師数\n(うち女性医師数)",null,"常　勤　　　人　(うち女性医師　　　人) "]
[null,null,"非常勤　　　人　(うち女性医師　　　人)"]
["貴院におけるベ ビーシッター等の活用に対する\n助成制度の内容",null,"※ 貴院における制度の内容について、予定案でかまいませんので、記入してください。    "]
[null,null,"１　助成制度の有無"]
[null,null,"　　・ 有 "]
[null,null,"　　・ 無　 ⇒ 　制度創設の予定時期(令和　　   年　　   月頃) "]
[null,null,"２　助成制度の対象となる保育サービスの内容"]
[]
[]
[]
[null,null,"３　助成制度の対象となる職員の範囲"]
[]
[]
[]
[null,null,"４　助成制度の内容(補助率や上限額など)"]
[]
[]
[]
["制度の利用見込みについて",null,"※ 利用予定者数、利用する予定の保育サービス、利用開始予定時期等について、記入してください。"]
[]
[]
[]
["経費見込み額",null,"※ 対象となる女性医師等ごとに記入し、合計額を記入してください。"]
[null,null,"〔 ベビーシッター等保育サービスの利用料金の見込み額 〕"]
[{"$nulls":3},"女性医師等Ａ",{"$f":"C63","v":{"v":0,"d":"0 "}},null,"円"]
[{"$nulls":3},"女性医師等Ｂ",{"$f":"D63","v":{"v":0,"d":"0 "}},null,"円"]
[{"$nulls":3},"女性医師等Ｃ",{"$f":"E63","v":{"v":0,"d":"0 "}},null,"円"]
[{"$nulls":3},"女性医師等Ｄ",{"$f":"F63","v":{"v":0,"d":"0 "}},null,"円"]
[{"$nulls":3},"女性医師等Ｅ",{"$f":"G63","v":{"v":0,"d":"0 "}},null,"円"]
[{"$nulls":3},"合　　　計",{"$f":"SUM(E33:F37)","v":{"v":0,"d":"0 "}},null,"円"]
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[null,"〔 サービス利用料金の見込額の内訳 〕"]
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[{"$nulls":7},"(単位：円)","（事業者は入力不要です。）"]
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[null,"５月",{"v":0,"d":"0 "},{"v":0,"d":"0 "},{"v":0,"d":"0 "},{"v":0,"d":"0 "},{"v":0,"d":"0 "},{"$f":"SUM(C52:G52)","v":{"v":0,"d":"0 "}},{"v":0,"d":"0 "},{"v":0,"d":"0 "}]
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[null,"７月",{"v":0,"d":"0 "},{"v":0,"d":"0 "},{"v":0,"d":"0 "},{"v":0,"d":"0 "},{"v":0,"d":"0 "},{"$f":"SUM(C54:G54)","v":{"v":0,"d":"0 "}},{"v":0,"d":"0 "},{"v":0,"d":"0 "}]
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[null,"９月",{"v":0,"d":"0 "},{"v":0,"d":"0 "},{"v":0,"d":"0 "},{"v":0,"d":"0 "},{"v":0,"d":"0 "},{"v":0,"d":"0 "},{"v":0,"d":"0 "},{"v":0,"d":"0 "}]
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[null,"(様式第４号)"]
["宿直等代替職員活用支援事業 事業計画書"]
["医療機関名",null,null,""]
["所在地",null,null,"〒"]
["代表者名",null,null,""]
["担当者の \n所属・氏名",null,null,"(所属)          ",{"$nulls":3},"(氏名)"]
["電話番号",{"$nulls":6},"FAX番号"]
["E-mailアドレス",null,null,""]
["医師数\n(うち女性医師数)",null,null,"常　勤　　　人　(うち女性医師　　　人) "]
[{"$nulls":3},"非常勤　　　人　(うち女性医師　　　人)"]
["貴院における\n宿直等代替職員\n活用支援の内容",null,null,"※貴院における制度の内容について、予定案でかまいませんので、記入してください。    "]
[{"$nulls":3},"１　宿直等代替職員の確保の方法 "]
[]
[]
[]
[{"$nulls":3},"２　宿直等代替職員に対する支給内容(手当額等)"]
[]
[]
[]
["支援の見込みに\nついて",null,null,"※ 支援予定者数、支援開始予定時期等について、記入してください。"]
[]
[]
["経費見込み額",null,null,"女性医師等の代替として宿直等に勤務する非常勤勤務医師の人件費(宿直等手当)"]
[{"$nulls":3},{"$f":"J47","v":{"v":0,"d":"0 "}},{"$nulls":3},"円"]
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[null,"〔 人件費の見込額の内訳 〕"]
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[{"$nulls":11},"(単位：円)","（事業者は入力不要です。）"]
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[null,"(様式第５号)"]
["女性医師等復職研修支援事業 事業計画書"]
["医療機関名",null,null,""]
["所在地",null,null,"〒"]
["代表者名",null,null,""]
["担当者の \n所属・氏名",null,null,"(所属)          ","(氏名)"]
["電話番号",{"$nulls":3},"　　FAX番号"]
["E-mailアドレス",null,null,""]
["医師数\n(うち女性医師数)",null,null,"常　勤　　　人　(うち女性医師　　　人) "]
[{"$nulls":3},"非常勤　　　人　(うち女性医師　　　人)"]
["貴院における\n女性医師等復職\n研修の内容",null,null,"※貴院における研修の内容について、予定案でかまいませんので、記入してください。    "]
[{"$nulls":3},"　研修を実施する診療科が複数ある場合は、診療科ごとに記入してください。"]
[]
[{"$nulls":3},"１　研修を実施する診療科名 "]
[]
[]
[{"$nulls":3},"２　受入可能な研修受講者数"]
[]
[]
[{"$nulls":3},"３　標準的な研修期間"]
[]
[]
[{"$nulls":3},"４　研修内容"]
[]
[]
[{"$nulls":7},"（事業者は入力不要です。）"]
["経費見込み額",null,null,"復職研修の実施にかかる経費の見込み額",{"$nulls":3},"基準額","選定額"]
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