Registration – Specialists

Registration – Medical Specialists

Username* Usernames cannot be changed.
Password* Type your password.
Salutation*
First Name*
Last Name*
Specialty*
Provider Number* (6 numbers 2 alphabet letters or 7 numbers and 1 alphabet letter)
Prescriber Number*
AHPRA Number* (must start with three alphabet letters)
Personal Details
Mobile Number*
Pager Number
E-mail*
Practise Details
Practise Managers/Nurse Name*
Office Number*
Office Fax*
Office Email*
Address*
Mailing*
Communication
Clinical Communication*
Written Correspondence*
Indemnity Insurance
Specialists must hold professional indemnity insurance cover issued by an Australian insurer, appropriate to your Scope of Practice? *
- Y
- N
Nominated Alternative Specialist
Salutation*
First Name*
Last Name*
Mobile*
CAPTCHA*