ACT Government Medical Booking Form – Bimberi Youth Justice Centre "*" indicates required fields Applicant DetailsName* First Last Phone number*Date of birth* DD slash MM slash YYYY Email* Preferred Clinic Location*Please select from the drop-down menuQueanbeyanDeakinDirectorateCommunity Services (Bimberi Youth Justice Centre)Position title* Medical Components Required:* Standard Pre-employment Medical; Audiometry; Spirometry; Instant Drug and Breath Alcohol; Functional Assessment Appointment DetailsAvailable dates from:* MM slash DD slash YYYY Available dates to:* MM slash DD slash YYYY Preferred appointment times* Monday AM Monday PM Tuesday AM Tuesday PM Wednesday AM Wednesday PM Thursday AM Thursday PM Friday AM Friday PM Please specify any special requirements Upload filesPlease upload any previous medical records, medical management plans, or any other relevant documentation.Max. file size: 200 MB.Comments
