VAHPA Advanced Scope Workshop Registrations 2017 Question Title * 1. Your details. First Name Family Name Mobile Non-work Email Profession Position Title Grade Question Title * 2. Primary Public Sector Employer Albury Wodonga Health Alexandra District Hospital Alfred Health Alpine Health Austin Health Bairnsdale Regional Health Ballarat Health Barwon Health Bass Coast Regional Health Beaufort & Skipton Health Service Benalla Health Service Bendigo Health Calvary Health Castlemaine Health Central Gippsland Health Cobram District Health Cohuna District Health Colac Area Health Dental Health Service Djerriwarrh Health Service Dunmunkle Health Service East Grampians Health East Wimmera Health Service Eastern Health Echuca Regional Health Edenhope & District Memorial Hospital Gippsland Southern Health Service Goulburn Valley Health Heathcote Health Hepburn Health Service Hesse Rural Health Service Heywood Rural Health Inglewood & District Health Service Kerang District Health Kilmore & District Health Kooweerup Regional Health Service Kyabram & District Health Service Kyneton District Health Service Latrobe Regional Hospital Lorne Community Hospital Maldon Hospital Mallee Track Health & Community Service Mansfield District Hospital Maryborough District Health Service Melbourne Health Mercy Health Mildura Base Hospital Monash Health Mayne Health Service Natalia District Hospital Northeast Health Wangaratta Northern Health Numurka District Health Service Omeo District Health Orbost Regional Health Otway Health & Community Service Peninsula Health Peter Mac Portland District Health Robinvale District Health Service Rochester & Elmore District Health Service Royal Children's RVEEH Rural Northwest Health Seymour Health South Gippsland Hospital South West Healthcare St Vincent's Stawell Regional Health Sunbury Community Health Swan Hill District Health Tallangatta Health Service Terang & Mortlake Health Service Timboon & District Health Care Service Upper Murray Health & Community Services West Gippsland Healthcare Group Western Health Wimmera Health Care Group Yarram & District Health Service Yarrawonga District Health Service Yea & District Memorial Hospital The Women's Other (please specify) Question Title * 3. Please indicate which Advanced Scope workshop you would like to attend; both workshops will be afternoon sessions and exact times and venue details will be advised shortly.Stream DetailsTherapeutic & Clinical Stream: AHDs, EPs, Music Therapists, OTs, Orientation & Mobility Practitioners, Orthoptists, Physios, Play Therapists, Podiatrists, Prosthetists/Orthotists, Speech Pathologists.Radiation & Imaging Stream: Bone Densitometrists, Mammographers, Medical Officers, MITs, NMTs, Radiation Engineers, RTs, Sonographers. Therapeutic & Clinical Stream Workshop - Tuesday 2 May, 2017 Radiation & Imaging Stream Workshop - Thursday 1 June, 2017 Question Title * 4. If you are a regional Delegate, do you require assistance with travel and/or accommodation? Yes (Please provide details below) No Other (please specify) Question Title * 5. Do you have any dietary requirements or restrictions? No Yes - Please specify Question Title * 6. Do you have any questions? Question Title * 7. Office Use Only 1 - Letter & confirmation emailed Other (please specify) Done