Assistance During an Emergency/Pandemic Response

Background

EMPHN is updating our register of primary care providers willing to assist with community responses during an emergency/pandemic response.

During crisis responses, Primary Health Networks may be requested by government and health sector stakeholders to engage primary care providers to support response efforts, either individually or at a whole‑of‑practice level.

We invite all primary health care providers including GPs, nurses, practice administrative staff, pharmacists, allied health professionals, and others to register their interest in participating in emergency response activities.

If you would like to support your community in times of need, we invite you to join our pool of health care volunteers. To register your interest, please complete the survey below.

Registration Form

Complete this form to register your willingness to support in emergency situations.

Question Title

* 1. Full Name

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* 2. Email

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* 3. Contact Phone (mobile preferred)

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* 4. Role

General Practitioner

GP Registrar

Registered Nurse

Enrolled Nurse

Pharmacist

Medical Receptionist

MH Practitioner or Nurse

Counsellor

Allied Health

Practice Manager

Other (please specify)

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* 5. AHPRA registration number (if applicable)
To comply with Australian Government Department of Health, Disability and Ageing requirements, all volunteer health clinicians must hold current registration with the Australian Health Practitioner Regulation Agency (AHPRA).

Assistance during an emergency (individual)
Please note, when an emergency occurs, we will contact you to confirm your capacity to perform the below tasks.

Question Title

* 6. In an emergency, I am willing to:
(Tick all that apply)

Support other primary care providers in affected areas in our region

Provide clinical assistance to residential aged care services that might be relocated

Work in an emergency response site set up in the community

Be deployed to another organisation to assist in an emergency situation (i.e. a hospital or community health centre)

Other (please specify)

Assistance during an emergency (practice)
Please note, when an emergency occurs, we will contact your practice to confirm its capacity to perform the below tasks.

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* 7. Practice Name

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* 8. Post code

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* 9. Practice Phone (mobile preferred)

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* 10. In an emergency, my practice/clinic is willing to:
(Tick all that apply)

Extend opening hours

Provide care to new patients

Provide outreach services

Take on additional services

Provide ancillary services (such as imaging or pathology)

Provide emergency care services (such as immunisations and respiratory checks)

Provide clinical assistance to residential aged care services that may be relocated

Accommodate lower acuity patients transported by ambulance or other emergency service vehicles

Loan staff or equipment to other service providers

Other (please specify)

Comments/questions

Assistance During an Emergency/Pandemic Response

Background

Question Title

* 1. Full Name

Question Title

* 2. Email

Question Title

* 3. Contact Phone (mobile preferred)

Question Title

* 4. Role

Question Title

* 5. AHPRA registration number (if applicable)To comply with Australian Government Department of Health, Disability and Ageing requirements, all volunteer health clinicians must hold current registration with the Australian Health Practitioner Regulation Agency (AHPRA).

Question Title

* 6. In an emergency, I am willing to:(Tick all that apply)

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* 7. Practice Name

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* 8. Post code

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* 9. Practice Phone (mobile preferred)

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* 10. In an emergency, my practice/clinic is willing to:(Tick all that apply)

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* 11. If you have any further comments or queries, fill in this section and EMPHN will be in touch shortly.

* 5. AHPRA registration number (if applicable)
To comply with Australian Government Department of Health, Disability and Ageing requirements, all volunteer health clinicians must hold current registration with the Australian Health Practitioner Regulation Agency (AHPRA).

* 6. In an emergency, I am willing to:
(Tick all that apply)

* 10. In an emergency, my practice/clinic is willing to:
(Tick all that apply)