WASHA Inc.
WA Simulation in Healthcare Alliance Inc. Membership Form
Please provide the following information to become a member of WASHA. If you have any concerns please contact us at: secretary@washa.org.au
*
indicates required
Name:
Email:
Comment:
Title/Salutation *
First Name *
Surname *
Email Address *
*
Phone *
Please name a current WASHA member who knows you.*
Employer
Job Title
Profession *
Audiology
Dietetics
Education
Health Governance
Medicine
Nursing/Midwifery
Occupational Therapy
Paramedicine
Physiotherapy
Podiatry
Social Work
Speech Pathology
Other
Healthcare Sim Interests - tick all that apply
Assessment
Curriculum Development
Debriefing
Faculty Development
Moulage
Research
Scenario Design
Simulated Patients
Technical (AV/Manikin)
WASHA Activities - tick all that apply
Educational activities
Information about funding opportunities
Mentoring opportunities
Networking opportunities
Research events
Stakeholder engagement (incl. national and international groups, State & Federal government agencies
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