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Registration and training
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Name
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First Name
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Email
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Specialty
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Gastroenterology
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*Optional: this will only be used to pre-fill your PBS authority forms
RA number
*Optional: this will only be used to delegate the upload of your PBS authority forms to a Medflow nurse
APHRA number
Verification purposes only
Clinic name
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Clinic phone number:
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*If applicable
Clinic address
Street name/number
Street Address
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What is the best date and time to arrange a Zoom meeting?
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Date
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Agreement
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