Registration: Aged Care Sector Workshop for the Revised WA Advance Health Directive

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Closes 13 Aug 2020

Your Registration Details

1. Please provide your full name below
2. What are your Contact details?

You will automatically receive an acknowledgement email when you submit your response.

3. Your role

Which category best describes your role?

4. Please indicate any dietary requirements below:
5. Please indicate any accessibility needs/requirements below:
6. Release and Consent

I give consent to be filmed, photographed, recorded and/or interviewed (‘the Material’) by Department of Health.

I give the Department of Health or other public health providers the right to use the Material for the purpose of promoting public health in any way, including but not limited to:

  • broadcasting or publishing the Material
  • communicating the Material to the public
  • reproducing or creating derivative works of the Material in any way including but not limited to film, posters, brochures, audio, video and websites
  • reproducing quotes and interview text, in written, audio, video or other formats.
(Required)