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Surname
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First name
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Mobile phone number
Position title
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Enrolled Nurse
Aboriginal and Torres Strait Islander Health Practitioner
Ambulance Officer
Clinical Nurse Consultant
Clinical Nurse Educator
Clinical Nurse Manager
Clinical Nurse Specialist
Consultant
Dentist
Dietician
Endorsed Enrolled Nurse
Environmental Health Officer
Emergency Service Personnel
Emergency Management
Fellow
Fire and Rescue Officer
Intern
Medic
Medical Officer
Nurse Unit Manager
Nursing Officer
Occupational Therapist
Paramedic
Pharmacist
Physio
Police officer
Remote Area Nurse
Registrar
Registered Midwife
Registered Medical Officer
Registered Nurse
Registered Nurse and Registered Midwife
Resident
Rural Medical Practitioner
Specialist Remote Medical Practitioner
Remote Medical Practitioner
Other
Date of Birth
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Date
E.g., 27 Sep 2023
Username
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E-mail address
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A valid e-mail address. All e-mails from the system will be sent to this address. The e-mail address is not made public and will only be used if you wish to receive a new password or wish to receive certain news or notifications by e-mail.
Password
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Confirm password
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Provide a password for the new account in both fields.
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