MyImpactPage - Application Form - Epworth Consumer Advisors

Eligibility Criteria

Eligibility criteria

I am at least 18 years of age
I am willing to undergo a national volunteer police check
I am willing to complete a working with children check
I am willing to sign and abide by a confidentiality agreement
I am willing to provide evidence of being fully vaccinated against COVID-19
I am willing to comply with all relevant Epworth HealthCare policies, procedures, values, behaviours and code of conduct
I am willing to undertake orientation and training as required
I am willing to provide at least 1 professional referee
I am not a current or previous employee of Epworth
I am not currently employed as a healthcare professional (nurse, doctor, allied health etc.)
I do not have any real and / or perceived conflict of interests
I do not have an open / ongoing complaint against Epworth or its affiliates, an Epworth Board Member, employee, or a Visiting Medical Officer who practices at Epworth or a service provider located within Epworth (e.g. Pharmaceutical, Pathology, Radiology)

I am new to MyImpactPage.com

You will need to enter a unique username to identify yourself to the system. You should select something that is easy for you to remember such as your email address or your name. Your username must be at least 6 characters long. If the name you enter is already in use by someone else, you will be prompted to choose another username.

Username

Required

	Username must not start with space
	Username must not end with space
	Username must not have two or more spaces in a row

Email Address

Required

Verify Email Address

Required

I have read and agree to the eligibility criteria Required

I already have a username

If you have signed up with this organization before, or are a member of another organization that uses MyImpactPage.com, you can use the same login to access all organizations with which you are associated.

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Password	Required
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I have read and agree to the eligibility criteria Required

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