Online Registration

Austwide Locums Online Registration

To start the registration process, please complete the form below, ring us or email us (see Contact Us). For phone or email enquiries, we’ll either email or express post the necessary documentation to you.

An Austwide Locums specialist placement consultant will contact you after you submit your application to help you with the registration process.

Once registered, you will be supplied with an ID Badge and given access to all shifts available on our website with your personal access code.

Personal information
Name*
Title
First
Last
Address
Street Address
Address Line2
City
State / Province / Region
Postal/ Zip Code
Country
Gender
Contact Details
Phone*
Preferred Method of Contact*
 Yes No

In order for us to assist you further in your application, would you please provide us with some optional information. *

 Yes, I would like to provide further information No, I wish to submit as is