Practice Information

* 1. Full name of person completing report

* 2. Practice Name

* 3. Registered Business Name

* 4. Postal Address

* 5. Email Address

* 6. Practice reception number

* 7. Practice Fax Number

* 8. Number of GP's involved in After Hours

* 9. Medicare Australia PIP Standardised Whole Patient Equivalent (SWPE) number

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