ACT Government Medical Booking Form "*" indicates required fields Standard Pre-employment Medical Applicant DetailsName* First Last Phone number*Date of birth* DD slash MM slash YYYY Email* Preferred Clinic Location*QueanbeyanDeakinDirectorate*Canberra Health ServicesCommunity ServicesCorrective ServicesEducation and TrainingJustice and Community SafetyParks and ConservationTransport Canberra and City ServicesEnvironment and PlanningBimberiOther (please detail)Position title* Recruiter Email* Appointment DetailsAvailable dates from:* MM slash DD slash YYYY Available dates to:* MM slash DD slash YYYY Preferred appointment times* Monday AM Monday PM Tuesday AM Tuesday PM Wednesday AM Wednesday PM Thursday AM Thursday PM Friday AM Friday PM Please specify any special requirements Upload filesPlease upload any previous medical records, medical management plans, or any other relevant documentation.Max. file size: 200 MB.Comments
