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AM I ELIGIBLE?

Prescriber Public Directory Listing Form

"*" indicates required fields

This is the name shown on your profile.
This email address will be used for internal communication and when sending notifications to you from the website.
Profile Image*
This image will be visible to users.
Accepted file types: jpg, jpeg, png, gif.
This Bio will be visible to users, along with your areas of interest, spoken languages, qualifications and experience.
If your booking system can be opened in an iframe, please paste the URL here.
Are you interested in participating in:*
Please tick all that apply.
Appointment Types Offered:*
Please tick all that apply.
Medication Types Offered:*
Please tick all that apply.

Fees

All fees to be in $AUD before Medicare rebate. These fees will be shown by default.
Add notes regarding the fees. These will be shown to the user.

Endorsed by

MSRA_logo_rbg
chronic-pain-aust
HIF_square_logo_no_tagline
eaa-master

Curtin University Human Research Ethics Committee (HREC) has approved this study (HRE2022-0085).