Assistance during an emergency/pandemic response

Background

Eastern Melbourne Primary Health Network are refreshing our list of local primary care providers who are willing to provide assistance during an emergency/pandemic response.

During crisis responses, Primary Health Networks may be asked to engage primary care providers in the catchment who are willing to assist with the emergency response. This could be on an individual or a whole-of-practice basis. These requests may come from stakeholders such as the Victorian Department of Health, the Commonwealth Department of Health, hospitals, local governments and others.

'Emergency' in this case is a broad definition and could be a natural disaster, accident or as part of a pandemic response.

We are inviting GPs, GP registrars, nurses, nurse practitioners, practice managers and pharmacists to complete this survey to register their interest in assisting in an emergency response. Participation is voluntary and you may remove yourself from this list at any time.

In the case that a local response is required, we may reach out to people who have registered to request their assistance. Information will be provided on a case-by-case basis to help practitioners determine if they are willing to help at that time.

This survey has two sections:
1. Individual assistance
2. Organisation assistance
If you are unable to respond on behalf of your organisation you do not need to complete section 2.

Question Title

* 1. Would you be willing to assit in an emergency/pandemic situation?

Yes

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* 2. Please provide your details:

First Name

Surname

Suburb

Email Address

Mobile Phone Number

Question Title

* 3. I am a:

General Practitioner

GP Registrar

Registered Nurse

Enrolled Nurse

Nurse practitioner

Practice manager

Pharmacist

Other (please specify)

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* 4. Would you be willing to be deployed to another organisation to assist in an emergency situation (for example: a hospital)?

Yes

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* 5. Would you be willing to provide clinical assistance to residential aged care services who may be relocated?

Yes

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* 6. Would you be willing to provide support to other primary care providers in affected areas?

Yes