Drift Health Contractor Registration Documents

Hey team, please fill in the form below and provide the key documents for compliance purposes.

First Name *

Last Name *

Phone *

Email *

This will be used for our Practice Management System - Splose

Public Liability & Professional Indemnity Insurance Certificate *

Click to upload

PDF, DOC/DOCX, XLS/CSV, JPG/JPEG, PNG, GIF

AHPRA/ESSA Registration Certificate *

Click to upload

PDF, DOC/DOCX, XLS/CSV, JPG/JPEG, PNG, GIF

CPR/First Aid Certificate *

Click to upload

PDF, DOC/DOCX, XLS/CSV, JPG/JPEG, PNG, GIF

Driver's Licence *

Click to upload

PDF, DOC/DOCX, XLS/CSV, JPG/JPEG, PNG, GIF

Operating Hours *

Enter your operating hours (e.g. 9AM - 6PM... N/A if you're unable to work on those days)

Service Areas *

Profile Photo (To Be Displayed On Website for NDIS Clients) *

Click to upload

PDF, DOC/DOCX, XLS/CSV, JPG/JPEG, PNG, GIF

Working With Children Check Number (WWCC) *