Nurse Change of Details Form
Personal Details
Name
*
First Name
Last Name
If changed from your original application: Previous Name/s
Address
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Email
example@example.com
Phone Number
-
Area Code
Phone Number
Mobile Phone Number
Please enter a valid phone number.
Format: 0000000000.
Bank
Account Name
Account Number
BSB
Next of Kin Name
First Name
Last Name
Mobile Phone Number
Please enter a valid phone number.
Format: 0000000000.
Contact Number
-
Area Code
Phone Number
Super Fund Name
Fund Member Number
Fund USI Number
Designation
If your designation has changed from your original application. You must complete the following and provide documentation.
Previous Designation
Current Designation
Type of qualification
Completed Date
Upload your new qualification documentation
Browse Files
Drag and drop files here
Choose a file
Cancel
of
On a phone? No worries! Take a photo of your new qualification
Provide your Availability
Only select days/shifts you are availability to work.
Rows
AM
PM
ND
Monday
Tuesday
Wednesday
Thursday
Friday
Saturday
Sunday
AN/ DSW Skills
Only select areas you have had paid experience working in.
Rows
Experienced
Aged Care
Hospital
Community
Disability
First Aid Certificate
Browse Files
Drag and drop files here
Choose a file
Cancel
of
On a phone? No worries! Take a photo of your First Aid Certificate
Enrolled & Registered Nurse Skills
It is the responsibility of the nurse to ensure they practice within their area of clinical expertise. Therefore, basic skills and management practices have not been listed. You will be offered shifts in the areas you select.
Rows
Experienced
Medical Mental Health
Cardiac
Rehabilitation
Oncology
Palliative
Infectious Disease
Surgical
Cardiac Aged Care
Recovery
Tracking
Day Surgery
Gynaecology
Orthopaedics
Paediatrics
Midwife
Neonatal
Special Care Nursery
Mental Health
Drug & Alcohol Rehabilitation
Coronary Care
Emergency Department
Cardiac Catheter Lab
Aged Care
Management
Preceptor
Facilitator
IPN
School Nursing
Drs Rooms
Other Skills
Required Documents
Current National Police Clearance-Required 3 yearly
Browse Files
Drag and drop files here
Choose a file
Cancel
of
On a phone? No worries! Take a photo of your National Police Clearance
Uniform & App
Do you require a new uniform?
Yes
No
Do you require an ID Badge?
Yes
No
Do you have the Carestaff app and login details?
Yes
No
By signing below you confirm that all details provided are true and correct. You also agree that you have fully read and agree to all terms of the 'Casual Employment Agreement'
Submit
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