Step 1

First name *

Last name *

Email *

Mobile number *

State / Territory *Select...VICNSWQLDSAWATASACTNT

Postcode

Step 2

Profession *Select...General PractitionerMedical SpecialistPsychologistDietitianNurse PractitionerVeterinarianOther

AHPRA registration number *

AHPRA registration type *Select...generalspecialistprovisionallimited

Prescriber number

Medicare provider number

Current clinic / employer

Years of experience *Select...0-23-56-1010+

Step 3

Primary specialty *

Secondary specialties

DocTel services *Instant GP CareMental HealthWeight Loss & DietitianMedicinal CannabisVetCareOther (future services)

Consultation types offered *VideoPhoneAsynchronous messaging

Patient age groupsChildrenAdolescentsAdultsOlder adultsPets only

Step 4

Profile headline

Short professional bio *

Languages spoken

Have you worked in telehealth before? * Yes No

Tell us briefly about your telehealth experience

Preferred maximum consults per daySelect...510152025+

Anything you want the DocTel team to know (not shown to patients)

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