GP Partners | Emergency / pandemic register

Emergency / pandemic register

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Name
Practice
Address
Mobile		Yes, SMS allowed
Work phone
Home phone
Email
Other contact

How would you be prepared to respond during a local community emergency?		Assist at hospital, triage or welfare centre or similar Front line at the scene Treat minor injuries, patients at my practice

Would you be prepared to offer your services during an Influenza pandemic?		No Yes, I would be prepared to work in a Queensland Health clinic (on roster; with indemnity/insurance cover, accommodation, PPEand antivirual supplied).
* Security Code

* Compulsory Fields