Registration Form - Rural Health West

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Thursday 17 and Friday 18 March 2016
Perth | 8:30am-5:30pm
Prior to Rural Health West Annual Conference and Trade Exhibition 2016
Increasing access to high quality emergency education,
Rural Health West invites all medical practitioners to the
REACT course.
Supporting Western Australian medical practitioners to
expand their emergency skills and knowledge, the
REACT course will provide greater confidence in
managing emergencies in rural environments.
The REACT course includes major trauma and cardiac
arrest in both children and adults as well as associated
lifesaving procedural skills. It is facilitated by
experienced emergency physicians and is highly
interactive. Participants are predominantly involved in
practical skill stations and simulated scenarios.
The course fee is $2,200 (including GST). Cost is
inclusive of all course materials including skills
checklists, a skills and drills demonstration DVD,
textbook, formal skills assessment and lunch (including
light refreshments).
This workshop is accredited with The Royal Australian
College of General Practitioners (RACGP) and the
Australian College of Rural and Remote Medicine
(ACRRM) for continuing professional development
points and is approved for the Rural Procedural Grants
Program. Please contact your relevant College prior to
attending to ascertain your eligibility.
Should you be registering to attend this REACT course
as part of meeting your WACHS ED credentialing
requirements, Rural Health West is required to provide
assessment results to the relevant WACHS Regional
Medical Director.
To register, please complete and return the
registration form overleaf. All successful applicants
will receive written confirmation.
For more information contact the CPD Team on
T 08 6389 4500 E cpd@ruralhealthwest.com.au
Thursday 17 and Friday 18 March 2016
Perth | 8:30am-5:30pm
Prior to Rural Health West Annual Conference and Trade Exhibition 2016
REGISTRATION FORM
I am a
GP VMP
GP
Locum
Other
Name
Postal address
(This is the address where pre-workshop materials will be sent)
Telephone
Facsimile
Mobile
Email
Special dietary requirements
RACGP No.
ACRRM No.
Course fee: $2,200 (including GST)
Visa
/
Mastercard
(please circle)
Name on card
Card number
Expiry date
/
Cardholder’s signature
Rural Health West is required to provide assessment results to the relevant WACHS Regional Medical Director.
Please send this form to Rural Health West via F 08 6389 4501 | E cpd@ruralhealthwest.com.au
Cancellations received four weeks prior to the workshop will receive a full refund of workshop fee. Cancellations received fourteen (14) days
prior will receive a 50 per cent refund. Refunds for cancellations received with less than fourteen (14) days notice will be considered on an
individual case basis.
Rural Health West values and respects your privacy and personal details. Personal information is collected in accordance with our Privacy Policy which
can be viewed at www.ruralhealthwest.com.au/privacystatement.
Western Australian Centre for Remote and Rural Medicine Limited
|
ABN 29 123 188 367
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