ACT Government Medical Booking Form "*" indicates required fields Applicant DetailsName* First Last Phone number*Date of birth* DD slash MM slash YYYY Email* Preferred Clinic Location*Please select from the drop-down menuQueanbeyanDeakinDirectorate*Please ensure to select the directorate from the drop-down listCanberra Health ServicesCommunity ServicesCorrective ServicesEducation and TrainingJustice and Community SafetyParks and ConservationTransport Canberra and City ServicesEnvironment and PlanningBimberiACT Government Analytical LaboratoryOther (please specify detail in comment section)Position title* Please upload your Job Description (JD) in either pdf or word document (NOT the Letter of Offer with salary). If you do not have a JD, please ensure to request one from your recruiter. Without JD, your booking will not be proceeded.*Please upload your Job Description (JD) in either pdf or word document (NOT the Letter of Offer with salary). If you do not have a JD, please ensure to request one from your recruiter. Without JD, your booking will not be proceeded. Accepted file types: pdf, docx, docmx, docb, dotm, doc, Max. file size: 200 MB.Recruiter Email* AGS Number (if known) Invoice to be sent to (email address)* Medical Components Required* Standard Pre-employment Medical Audiometry Spirometry Instant Drug and Breath Alcohol Functional Assessment ECG Rail Medical (Category 2) Rail Medical (Category 3) Baseline Asbestos Examination Chest X-ray (ILO) (to be confirmed by assessing Dr) - Ony for Asbestos 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
