Immunisation Program | Practice Support

Title

Full name*

Email*

Phone Number*

AHPRA Registration Number*

Are you a registered nurse working in a general practice or RACH in the Blue Mountains, Hawkesbury, Lithgow or Penrith area?*

Yes No

Practice/RACH Name*

Practice/RACH Address*

Does your general practice or RACH endorse your training and support you in providing immunisations within your practice?*

Yes No

How long have you been employed at the general practice/RACH?*

Why would you like to undertake the 347 National Immunisation Program for Health Practitioners' course? (Max. 75 words)*

APPLICANT STATEMENT: I am aware that the mode of study is only available online with the Australian College of Nursing (ACN) from 21 days to a maximum of 120 days consisting of 80 CPD hours. In completing and submitting this EOI I understand the commitment to meet the assessment due dates to successfully complete the course and agree to the following:

Do you have access to study leave? (Please discuss this directly with your employer as it may support your learning)*

Yes No

Do you, the applicant, agree to commence the course immediately on receipt of the online details?*

Yes No

If you consider withdrawing, do you confirm to contact Wentworth Healthcare prior and acknowledge that if you withdraw you may be required to reimburse the total cost of the course fee?*

Yes No

Does your supervisor support you in undertaking the online immunisation course?*

Yes No

SUPERVISOR DETAILS
Please ensure that the details you provide below are for your practice manager, a principal GP, or facility manager.

Supervisor's Name*

Supervisor's position*

Supervisor's Email*

Immunisation Scholarships

Background

Vaccination authorities

Scholarship application process

Scholarship Expression of Interest form

Working with GPs & health professionals
for better health in our community.

Provider of the Nepean Blue Mountains Primary Health Network

Immunisation Scholarships

Background

Vaccination authorities

Scholarship application process

Scholarship Expression of Interest form

Working with GPs & health professionalsfor better health in our community.

Provider of the Nepean Blue Mountains Primary Health Network

Working with GPs & health professionals
for better health in our community.