ONLINE DR SERVICE USER APPLICATION
This form will register your interest in the campaign. From here you will receive details on the job (including pay and how to submit a quick audition).
Full Name
*
Agent (If you are not represented, please write 'Freelance')
*
Age
Phone Number
*
Email Address
*
please ensure this is correct as this is how we will send you job details.
State *We are accepting applications Aus-Wide*
*
Please Select
VIC
NSW
QLD
WA
SA
TAS
ACT
Please list your private healthcare insurer (e.g BUPA, NIB, Medibank etc)
*
What is your occupation
e.g "Tradie" or "Busy Mum" or "Teacher" etc
Please briefly tell us a bit about your experience with Online Dr Service through your private Healthcare Insurer:
*
Please upload a photo of yourself. Please ensure it's clear & current)
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