Medical EOIs: Rural & Remote Emergency Medicine Skills Workshop -Broome, 4 & 5 November 2023

Course*

First Name*

Surname*

Preferred Name

Profession*

Please note all nursing applications for this program are allocated by Kimberley Population Health Unit.

Current position*

Practice Name / Hospital Name*

Please include location and practice name if applicable

Clinical Department*

Mobile Phone*

Email Address*

Please note all correspondence relating to your application will be sent to this email address

Comments

Please provide any additional comments you may wish to include to support your EOI application.

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