Update GP information | General Practice Support

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Personal Details

Title*

First Name*

Last Name*

Preferred Name

Email Address*

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Phone Number

Preferred number to be contacted on

Practice/Organisation*

Additional Practice/Organisation

Full Name (per AHPRA registration)*

AHPRA/MED Number*

Must begin with 'MED'

HPI-I*

16 digits

Provider Number (PRN)*

Must include a letter as well as numbers

RACGP Number*

ACRRM Number*

Spoken Languages Other than English

Add me to the Wentworth Health Bilingual Healthcare Provider Directory

Areas of Specialty

If Other, Please Specify

Areas we can assist with

We can assist practice staff and primary care professionals in a range of areas. Please indicate if you would like:

A "New GP Orientation" visit A visit from a Primary Care Engagement Officer

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By completing this form you understand that your Personal Information is being collected in order to keep our records up to date (the Agreed Purpose). We will never share/release any identifiable information to any other party, unless required for the Agreed Purpose specified above or further advised to you. For further information on how we handle Personal Information please refer to our Privacy Policy.

Update Your Information

Personal Details

Areas we can assist with

I am interested in learning more about

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

Provider of the Nepean Blue Mountains Primary Health Network

Update Your Information

Personal Details

Areas we can assist with

I am interested in learning more about

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.