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Medcallz Health Ecosystem - Doctor & Health Provider Enquiry

Thank you for your interest in joining Medcallz.
We value your enthusiasm and commitment to excellence in telehealth. To ensure alignment with our high standards and service offerings, we follow a selective onboarding process.

Please complete a brief questionnaire to help us assess your expertise and suitability for collaboration.

Full Name *

Phone Number *

Email Address *

What type of practitioner are you? *

General Practitioner Fellow General Practitioner Registrar Specialist Fellow Specialist Registrar Nurse Practitioner Psychologist Pharmacist Others

What state are you based in? If not in Australia, please specify your location in the other box. *

ACT NSW NT QLD SA TAS VIC WA OT Others

Please provide your AHPRA registration number. *

Are you currently under a 10-year moratorium? *

Please select the services you are able to provide. (NOTE: all of our services are offered via telehealth) *

General practitioner consultation Specialist consultation Mental health care plans General practitioner care plans Medication reconciliation Medical certificate services Workers compensation/Injury management Skin care consults Weight lost consults Hair disorder consults Others

Roughly, how many days per week are you able to consult? *

1 Day 2 Days 3 Days 4 Days 5 Days 6 Days 7 Days

Roughly, how many hours per week are you able to consult? *

Below 10 hours 10-20 hours 20-30 hours 30+ hours

What days of week can you consult? *

Monday Tuesday Wednesday Thursday Friday Saturday Sunday Varies

Please select the type of shifts you can offer. (NOTE: all options refer to within your own time zone) *

Early morning shifts Within standard business hours Evening/late night shifts Overnight shifts Weekends Varies

Do you have acccess to PRODA? *

Yes No Unsure

Are you limited to the amount of provider numbers you can have? *

Yes No Unsure

Anything else we should know?

WA MED,
PO BOX 5196, Canning Vale south,
Western Australia 6155

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