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* 1. Please tell us about yourself

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* 2. What is your employee number?

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* 3. What date did you commence employment with Ambulance Victoria?

Date

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* 4. Please provide the following details for any cycle where you did not have a CI/PE?
Month
Roster Cycle Number
Branch

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* 5. What impact, if any, did you experience due to not being rostered with a CI?  

T