Access Canberra Medical Booking Form "*" indicates required fields Applicant detailsFirst Name*Last Name*Position Title*Date of Birth DD slash MM slash YYYY Please upload your position description*Max. file size: 2 MB.Email Address* Mobile Number*Employment Status*Select one of the belowAre you a new employee to Access Canberra?Are you an existing employee to Access Canberra?Medical Components Required* Skin Screening (Solar Radiation) Audiometry Asbestos Screening Preferred Clinic Locatioon*Select one of the belowACT - DeakinNSW - QueanbeyanInterstate (please enter the preferred location below)Interstate*1st Suitable Date* MM slash DD slash YYYY 1st Suitable Time* Hours : Minutes AM PM AM/PM 2nd Suitable Date* MM slash DD slash YYYY 2nd Suitable Time* Hours : Minutes AM PM AM/PM 3rd Suitable Date* MM slash DD slash YYYY 3rd Suitable Time* Hours : Minutes AM PM AM/PM CommentsThis field is hidden when viewing the formDays* Monday AM Monday PM Tuesday AM Tuesday PM Wednesday AM Wednesday PM Thursday AM Thursday PM Friday AM Friday PM This field is hidden when viewing the formAvailable From:* DD slash MM slash YYYY This field is hidden when viewing the formAvailable To:* DD slash MM slash YYYY This field is hidden when viewing the formAvailability for appointment:The clinic will send you an email confirming your appointment time and location. Please pay attention to booking confirmation email. If you have any concerns please email Aspen Corporate Health Team at bookings@aspencorporatehealth.com.au. If you do not attend your appointment, or do not give adequate notice of cancellation [no less than 24 hours], a cancellation fee will be charged to the Department.Please also bring a photo ID with you to the appointment, a driver license for example.
