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* 1. Honorific

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* 2. First name

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* 3. Last name

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* 4. Email

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* 5. Position title

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* 6. Organisation(s)

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* 7. Discipline(s)

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* 8. Qualifications

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* 9. Postcode

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* 10. AHPRA number

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* 11. If you do not have an AHPRA number, please provide a short statement of interest

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* 12. Declaration

The Victorian Comprehensive Cancer Centre (VCCC) and Monash Partners Comprehensive Cancer Consortium (MPCCC) have developed the Victorian COVID-19 Cancer Network (VCCN), a collaboration platform to provide assistance and share documentation generally related to the care of patients with cancer during the COVID-19 pandemic.

ACCEPTANCE

By clicking ‘I Accept’ you have read and agree to the Terms & Conditions, and agree to independently verify the accuracy, credibility, validity and reliability of any information, document, recommendation, opinion, statement or otherwise contained on the VCCN. You agree that the VCCC and MPCCC are not responsible for any outcome or result arising whatsoever from the information provided. 

You agree to comply with the requirements of the Privacy Act 1988 (Cth) and the Health Records Act 2001 (Vic) and must not disclose any Personal Information of another with respect to information shared on the VCCN and in connection with this Agreement except to the extent that such disclosure would not contravene any applicable Privacy Law. You should consider your own circumstances and are encouraged to consider or seek professional advice on the matters in this Agreement and as published on the VCCN. 

Download a copy of the Terms & Conditions.

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* 13. Want to stay in touch with us?

Check the relevant box to join a mailing list for news and event updates.

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