ASPREN Registration Form

GP Details: Please provide details for all GPs or nurse practitioners at the practice that will be participating in ASPREN
GP or nurse practitioner Information
Additional Information
Reporting Levels
Silver - reporting Influenza Like Illness (ILI) only
Gold - reporting ILI, Gastro, Chicken Pox and Shingles
Platinum - reporting ILI, Gastro, Chicken Pox, Shingles and Swab Testing 20% of ILI patients
CPD Points Allocation
It is important that the GPs RACGP or ACRRM numbers are provided to ensure their points are allocated
Email Address
CPD point accrual information, payment information and other important reporting reminders are sent to reporters via email. Therefore it is imperative that we have a direct email address for participating reporters - not a generic practice email.
ASPREN Training
Upon receiving the completed form an ASPREN team member will be in contact with the practice manager to arrange a day and time for the participating GPs and/or practice managers to receive ASPREN training.