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Name:
Email:
Comment:
Email Address
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First Name
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Last Name
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Post Code
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My role
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Nursing (in clinical and/or care management roles)
Care Worker/Community Support Worker
Doctor/Medical Professional
Allied Health Professional
Educator/Manager
Support and Lifestyle Staff (Non-Nursing)
Other
Where I provide care
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Residential Aged Care
Home Care
Primary Care
Specialist Palliative Care
Hospital (Tertiary care)
Training Education Provider
Other
My service supports (tick all that apply):
Aboriginal and Torres Strait Islander people
Culturally and Linguistically Diverse people
LGBTIQ+
Other
Does not apply
