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Application Form
Your Name
*
Phone Number
Email
*
Your degree
Year of Graduation and from which University
Outline your experience as an EP specifically in the compensable schemes incl. Workcover, CTP or motor accidents and Life Insurance
As an EP have you performed case conferences, workplace assessments and designed RTW Plans?
Where are you based?
Are you currently employed, working as a contractor or in private practice?
Do you have professional indemnity insurance?
Are you a member or ESSA
Yes
No
In less than 25 words, why are you an EP?
What conditions do you love to treat?
What conditions would you like to learn the most about in the next 12-24 months?
What do you do to maintain your own health and fitness?
What’s the last book you read that you couldn’t put down?
What is your favourite documentary?