Physiotherapist

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Personal Details

First name

Last name

Mobile

Address Line 1

Address Line 2

Suburb

Postcode

Country

Right to Work

Do you have the right to work in Australia?

Compliance

Do you have a NDIS Workers Screening Check?

Health Declaration

Do you have any pre-existing illness or injury which may impact on your ability to safely perform the inherent requirements of this position?

If yes, please describe

Do you have any health conditions which may affect your ability to perform your duties?

If yes, please describe

Would you be willing to undertake a Pre-employment Medical or a Fitness for Work Assessment?

Travel

Do you have a current driving licence with no restrictions?

Applicant Details

Have you previously been employed/interviewed by MSWA?

If yes, please provide Dept, Location & Manager

Have you been referred by an existing MSWA employee?

If yes, please provide employee's name

Desired Salary

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Permission to retain details for other positions

Employee Referral:

Have you been referred by a current MSWA team member?

Please put down the name of the person who referred you below:

Please put down the job title of the person who referred you below:

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