Primary Health Emergency Response

In conjunction with the Victorian Department of Health (DOH), SEMPHN contributes to preparations for responding to state emergencies.

We are looking for health professionals, managers, and practices/organisations that are willing to volunteer their time in the event of an emergency.

For example, during a bushfire or flood where extra help is needed, this information will help us to know who DOH can call upon.

During a state emergency, SEMPHN may send you a text message/SMS alert, asking if you are available to respond.

We will share the information you give us in the survey with DOH. We will ask every six months for an update on your details and if you are willing to stay on the list.

By completing this survey you are agreeing to go on the list and be contacted by text message/SMS in the event of a state emergency.

Question Title

* 1. Your Profession

General Practitioner

Practice Nurse

Community Nurse

Community Pharmacist

Manager

Question Title

* 2. First Name

Question Title

* 3. Last Name

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* 4. Mobile Number
Your mobile number will be recorded in our system in a section reserved for emergency response. This data will only be used for the purposes of responding to an emergency or for updating details.

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* 5. Email address

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* 6. Practice / Organisation name

Question Title

* 7. Practice / Organisation address

Street address

Suburb

Postcode

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* 8. Organisation type

General practice

Pharmacy

Community nursing/care

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* 9. Are you willing to: (tick all that apply)

Extend opening hours

Provide outreach services

Take on new/extra patients

Provide additional services, if required (e.g. immunisations, respiratory checks)

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

Provide mutual support to other primary care providers in affected areas

Thank you for agreeing to be contacted in the event of an emergency response being needed.
If you wish to change your mind or update your details, please email providersupport@semphn.org.au

Primary Health Emergency Response

Question Title

* 1. Your Profession

Question Title

* 2. First Name

Question Title

* 3. Last Name

Question Title

* 4. Mobile NumberYour mobile number will be recorded in our system in a section reserved for emergency response. This data will only be used for the purposes of responding to an emergency or for updating details.

Question Title

* 5. Email address

Question Title

* 6. Practice / Organisation name

Question Title

* 7. Practice / Organisation address

Question Title

* 8. Organisation type

Question Title

* 9. Are you willing to: (tick all that apply)

* 4. Mobile Number
Your mobile number will be recorded in our system in a section reserved for emergency response. This data will only be used for the purposes of responding to an emergency or for updating details.