National Mental Health Workforce Strategy Internship Provider Application Form

National Mental Health Workforce Strategy

Internship Provider Application Form
Flinders University is the recipient of a Department of Health and Ageing grant designed to support service providers by offsetting their costs when they facilitate Internships under the 5+1 (MPP) program. There are 100 Internship grant packages available to providers over the years 2024-2027.

Employers of provisional psychologists undertaking their Internship year following the completion of their MPP degree program, will be eligible to apply for:
- An Onboarding Payment to support set up costs associated with the internship;
- A Supervisor Support Package to support the costs of supervision during the internship;
- A Relocation Incentive Package in situations where an intern relocates to a regional or remote location.
To be eligible to apply for any of the above, an organisation must be approved as an internship provider and enter into an agreement with Flinders University regarding the use of the funds. A copy of this agreement will be sent to you following approval as an internship provider.

Please complete the below to register as an internship provider under the grant. This form will only need to be completed once during the term of the agreement, unless details vary.

AGENCY INFORMATION
AGENCY INFORMATION
Are you looking for a provisional psychologist to fill an internship or have you already identified one?

Yes - Actively looking for an internNo - We have already identified an intern for this position
Business Name
Postal Address

Address

Address Line 2

CityState

Postcode
Street Address

Street Address

Street Address Line 2

CityState

Postcode
Australian Business Number (ABN)
Contact Person

First NameLast Name
Position
Phone Number
Email
Alternate Contact

First NameLast Name
Alternate Email

SUPERVISOR INFORMATION
SUPERVISOR INFORMATION
Primary Supervisor

First NameLast Name
Phone Number
Email
Work Location
Is this person a board approved supervisor?

YesNo
Secondary Supervisor

First NameLast Name
Phone Number
Email
Work Location
Is this person a board approved supervisor?

YesNo

AREAS OF PRIORITY SERVICE
AREAS OF PRIORITY SERVICE
Please indicate if you are a priority service in one of the following areas

First NationsCulturally and Linguistically diverse (CALD)Regional, rural and remote areas

ORGANISATION DESCRIPTION
Please provide a brief description of the organisation, including service locations, staffing profile and services offered.
Should be Empty: