Renewals

Your Name Mr Mrs Ms Miss *

Email Address *

Home Phone

Bus. Phone

Mobile *

Your Address *

Suburb *

Postcode *

State *

NurseWise Member # *

AHPRA Registration No *

Qualifications *

Nurse Practitioners & Students $428.00 (includes GST $35.70)

Nuclear Medicine Technologists, Radiographers $478.00 (includes GST $39.90)

Cardiac Technologists $478.00 (includes GST $39.90)

Employed Midwives (including Prenatal and Birthing Suite, employed in Public or Private Hospitals only) $745.00 (includes GST $61.90)

Registered Nurse DIV 1 (EMPLOYEE) $310.00 (includes GST $26.00)

Enrolled Nurse DIV 2 Medication Certified $281.00 (includes GST $23.60)

Enrolled Nurse DIV 2 Non Medication Certified $264.00 (includes GST $22.20)

Self-Employed Registered Nurse DIV 1 $428.00 (includes GST $35.70)

Personal Care Attendant $264.00 (includes GST $22.20)

Volunteer Registered Nurse $242.00 (includes GST $20.40)

Occupational Therapists $242.00 (includes GST $20.40)

Paramedics $428.00 (includes GST $35.70)

Yes No Are there any claims alleging a negligent act, error or mission or malpractice currently lodged against you?

Yes No Are you aware of any circumstance which has already occurred which may give rise to a negligent act, error or omission or a malpractice claim being lodged against you?

Yes No Have you ever been involved in professional discipline procedures?

Internet Transfer/Deposit

Credit Card (Bank credit card charge to apply .87%)