Tuesday 9th July 2024

Please complete the following registration form.
Optometry Australia QA has been confirmed.

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1. Full Name - As per OA registration if applicable. (Required.)

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2. OA Membership number for CPD time allocation.

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3. Provider Number- If multiple locations, include all or the most relevant. (Required.)

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4. Clinic name and location you are practicing at. (Required.)

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5. Email address (Required.)

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6. Mobile Phone Number (Required.)

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7. Years since graduation

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8. How did you hear about this event?

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9. Would you like to join our WhatsApp Clinical Optometry portal, to gain access to case studies? If so, please tick yes and we will sign you up. (Required.)

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10. Would you like to receive newsletters, flyers and invitations to CPD events by Mail Chimp? (Required.)

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11. What type of delivery do you prefer? (Required.)

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