Register for Critical Care Essentials for Nurses
This form is now archived.
Please CLICK HERE to apply for Critical Care Essentials for Nurses 2021.
First Name
Last Name
Email
We recommend you to use your personal email address.
Our emails might be blocked or filtered by your hospital / company email server.
Gender
Please select...
Female
Male
X
Contact Number
Suburb
State
AHPRA Number
Months and years as a registered nures
Name of Employer
Please select...
Choice A
Choice B
Choice C
Area of Nursing
Critical Care Unit (Intensive care, Critical care, High dependency)
Emergency Department
Inpatient unit
Outpatient unit
Hospital in the Home
Other
Please confirm if you are happy to receive emails, invitation to events and updates from us
Yes
No
In order to enrol you must agree to the following
I acknowledge that I may liable for the full cost of the program in the event that I withdraw from the course or fail to complete the course within 12 weeks of enrolment.
I acknowledge that I may lose course access in the event I fail to complete the course within 12 weeks of enrolment
I have read and understood the
https://medicine.unimelb.edu.au/about/mobile-learning-unit#about
and I consent to my personal or health information being collected and processed as described, including being shared with the Federal, state and territory governments and agencies, including the Australian Health Practitioner Regulation Agency (AHPRA), as proof of activity and enrolment.
Contact Information