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First name
*
Last name
*
Email
*
Phone
*
Select a proposed start date which works for you
Are you currently registered with the Australian Health Practitioner Regulation Agency (AHPRA)?
*
Yes
No
Do you hold Fellowship with either the Royal Australian College of General Practitioners (FRACGP) or Australian College of Rural and Remote Medicine (FACRRM)?
*
Yes
No
Are you either an Australian citizen, permanent resident, or holder of a valid visa that permits medical practice?
*
Yes
No
Do you hold, or are clearly eligible to obtain, an active Medicare Provider Number (MPN)?
*
Yes
No
Do you hold, or can readily obtain, appropriate Professional Indemnity Insurance?
*
Yes
No
What kind of work are you looking for?
Full time telehealth services (more than 20hrs per week)
Part time / Appointment fill telehealth services (less than 20hrs per week)
Do you have a presence in an existing face-to-face practice which you will maintain alongside your Telehealth services with BulkBill.Doctor?
Yes - I have my own practice / rooms
Yes - I work for an existing clinic
No
What is the name of the clinic or practice with whom you currently work?
Describe your experience working in a face-to-face clinic or telehealth services (Australian only)
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