IAR Training Registration | 15th October 2024 Question Title * 1. First Name Question Title * 2. Surname Please refer to the Terms and Conditions under the Email for Attendee section. Please do not provide common or shared email addresses (e.g. admin@organisation.org.au OR staff@organisation.org.au) Question Title * 3. Email address Question Title * 4. Phone Number Question Title * 5. Stakeholder type PHN LHD Mental Health Service Provider Commissioned Providers Aboriginal Community Controlled Organisations General Practice School Question Title * 6. Health Profession GP GP Registrar Psychologist Lived Experience Representative Peer Worker Nurse inc Mental health Nurse Psychiatrist Allied Mental Health Clinicians Counsellor Intake Staff Specialist Other Question Title * 7. If you selected "Other" as Health Professions, please fill out your profession Question Title * 8. Place of Practice: Organisation Question Title * 9. Place of Practice: Suburb and Postcode Is your PRIMARY place of practice (i.e., where you practice most often) located in the WNSWPHN catchment? Each PHN is delivering IAR-DST training to their local area catchment. Please click here to confirm your place of practice is located in the WNSWPHN catchment before registering. If your place of practice is NOT in our catchment, please contact your local PHN to enquire about IAR-DST Training. Question Title * 10. Confirm your PRIMARY place of practice is located in WNSWPHN catchment No Yes If you answered 'No' above, please consider attending the National Training, or contact your local PHN for training in your area. Please refer to Terms and Conditions section Question Title * 11. Please provide your RACGP / ACRRM membership number. Question Title * 12. Payment and CPD hours are only applicable once, though you are welcome to attend the training again for a refresher. Please see T&Cs.Have you attended IAR-DST Training, either with WNSW PHN or another PHN? Yes No Question Title * 13. Agree to Terms and Conditions No Yes Question Title * 14. How did you hear about this training? Register