NATSIHWA 2012 National Health Worker Award nominations

1. YOUR DETAILS

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20% of survey complete.

We're updating our details in our databases and for the November forum & the 'National Aboriginal & Torres Strait Islander Health Worker Awards' ....so we can better support support you. Please let us know the following....

Question Title

* 1. Please provide NATSIHWA with your updated details (this will be kept confidential)

Name: *

Where I work *

Home address: *

Any other address:

City/Town: *

State/Territory:

Post Code: *

Best email to get you: *

Landline:

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* 2. I'm currently working in:

ACT

NSW

QLD

TORRES STRAIT

TAS

VIC

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* 3. Are you male or female?

Male

Female

Other

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* 4. Are you currently or previously a member of NATSIHWA, NT or nationally registered and/or WAAHWA

Yes - NATSIHWA

Yes - WAAHWA

Yes - Nationally registered under AHPRA

Yes - Previously registered in the NT

Yes - both NATSIHWA & WAAHWA

No - neither

Not sure

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* 5. If your not a NATSIHWA member (or not sure), would you like information on becoming a member?

Yes

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* 6. The best way to contact me is....

Mail - home

Mail - work

Email - home

Email - work

Phone - home

Phone - work

Don't contact me

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* 7. The qualifications/certificates I hold are:

	Cert II	Cert III	Cert IV	Diploma	Adv Diploma	Bachelor degree	Masters degree
Aborignal and/or Torres Strait Islander Primary Health Care (Clinical/Practice)	Aborignal and/or Torres Strait Islander Primary Health Care (Clinical/Practice) Cert II	Aborignal and/or Torres Strait Islander Primary Health Care (Clinical/Practice) Cert III	Aborignal and/or Torres Strait Islander Primary Health Care (Clinical/Practice) Cert IV	Aborignal and/or Torres Strait Islander Primary Health Care (Clinical/Practice) Diploma	Aborignal and/or Torres Strait Islander Primary Health Care (Clinical/Practice) Adv Diploma	Aborignal and/or Torres Strait Islander Primary Health Care (Clinical/Practice) Bachelor degree	Aborignal and/or Torres Strait Islander Primary Health Care (Clinical/Practice) Masters degree
Aborignal and/or Torres Strait Islander Primary Health Care (Community)	Aborignal and/or Torres Strait Islander Primary Health Care (Community) Cert II	Aborignal and/or Torres Strait Islander Primary Health Care (Community) Cert III	Aborignal and/or Torres Strait Islander Primary Health Care (Community) Cert IV	Aborignal and/or Torres Strait Islander Primary Health Care (Community) Diploma	Aborignal and/or Torres Strait Islander Primary Health Care (Community) Adv Diploma	Aborignal and/or Torres Strait Islander Primary Health Care (Community) Bachelor degree	Aborignal and/or Torres Strait Islander Primary Health Care (Community) Masters degree
Aborignal and/or Torres Strait Islander Primary Health Care (other)	Aborignal and/or Torres Strait Islander Primary Health Care (other) Cert II	Aborignal and/or Torres Strait Islander Primary Health Care (other) Cert III	Aborignal and/or Torres Strait Islander Primary Health Care (other) Cert IV	Aborignal and/or Torres Strait Islander Primary Health Care (other) Diploma	Aborignal and/or Torres Strait Islander Primary Health Care (other) Adv Diploma	Aborignal and/or Torres Strait Islander Primary Health Care (other) Bachelor degree	Aborignal and/or Torres Strait Islander Primary Health Care (other) Masters degree
Other primary care qualification (not specifically Aboriginal or Torres Strait Islander)	Other primary care qualification (not specifically Aboriginal or Torres Strait Islander) Cert II	Other primary care qualification (not specifically Aboriginal or Torres Strait Islander) Cert III	Other primary care qualification (not specifically Aboriginal or Torres Strait Islander) Cert IV	Other primary care qualification (not specifically Aboriginal or Torres Strait Islander) Diploma	Other primary care qualification (not specifically Aboriginal or Torres Strait Islander) Adv Diploma	Other primary care qualification (not specifically Aboriginal or Torres Strait Islander) Bachelor degree	Other primary care qualification (not specifically Aboriginal or Torres Strait Islander) Masters degree
Drug & Alcohol (specific qualification)	Drug & Alcohol (specific qualification) Cert II	Drug & Alcohol (specific qualification) Cert III	Drug & Alcohol (specific qualification) Cert IV	Drug & Alcohol (specific qualification) Diploma	Drug & Alcohol (specific qualification) Adv Diploma	Drug & Alcohol (specific qualification) Bachelor degree	Drug & Alcohol (specific qualification) Masters degree
Mental health and wellbeing (specific qualification)	Mental health and wellbeing (specific qualification) Cert II	Mental health and wellbeing (specific qualification) Cert III	Mental health and wellbeing (specific qualification) Cert IV	Mental health and wellbeing (specific qualification) Diploma	Mental health and wellbeing (specific qualification) Adv Diploma	Mental health and wellbeing (specific qualification) Bachelor degree	Mental health and wellbeing (specific qualification) Masters degree
Sexual health	Sexual health Cert II	Sexual health Cert III	Sexual health Cert IV	Sexual health Diploma	Sexual health Adv Diploma	Sexual health Bachelor degree	Sexual health Masters degree
Aged care, disability and/or home care	Aged care, disability and/or home care Cert II	Aged care, disability and/or home care Cert III	Aged care, disability and/or home care Cert IV	Aged care, disability and/or home care Diploma	Aged care, disability and/or home care Adv Diploma	Aged care, disability and/or home care Bachelor degree	Aged care, disability and/or home care Masters degree
Nursing	Nursing Cert II	Nursing Cert III	Nursing Cert IV	Nursing Diploma	Nursing Adv Diploma	Nursing Bachelor degree	Nursing Masters degree
Medicine	Medicine Cert II	Medicine Cert III	Medicine Cert IV	Medicine Diploma	Medicine Adv Diploma	Medicine Bachelor degree	Medicine Masters degree
Other Allied Health	Other Allied Health Cert II	Other Allied Health Cert III	Other Allied Health Cert IV	Other Allied Health Diploma	Other Allied Health Adv Diploma	Other Allied Health Bachelor degree	Other Allied Health Masters degree
Management	Management Cert II	Management Cert III	Management Cert IV	Management Diploma	Management Adv Diploma	Management Bachelor degree	Management Masters degree
Non-health	Non-health Cert II	Non-health Cert III	Non-health Cert IV	Non-health Diploma	Non-health Adv Diploma	Non-health Bachelor degree	Non-health Masters degree
No qualification (any but no ticks in boxes above or below)	No qualification (any but no ticks in boxes above or below) Cert II	No qualification (any but no ticks in boxes above or below) Cert III	No qualification (any but no ticks in boxes above or below) Cert IV	No qualification (any but no ticks in boxes above or below) Diploma	No qualification (any but no ticks in boxes above or below) Adv Diploma	No qualification (any but no ticks in boxes above or below) Bachelor degree	No qualification (any but no ticks in boxes above or below) Masters degree
Other	Other Cert II	Other Cert III	Other Cert IV	Other Diploma	Other Adv Diploma	Other Bachelor degree	Other Masters degree
None of the above (click any box)	None of the above (click any box) Cert II	None of the above (click any box) Cert III	None of the above (click any box) Cert IV	None of the above (click any box) Diploma	None of the above (click any box) Adv Diploma	None of the above (click any box) Bachelor degree	None of the above (click any box) Masters degree

Other (please specify)

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* 8. I'm thinking of, or would be interested in, upgrading to the following quaifications in the next 1 - 3 years...

	Cert II	Cert III	Cert IV	Diploma	Adv Diploma	Bachelor degree	Masters degree
Aborignal and/or Torres Strait Islander Primary Health Care (Clinical/Practice)	Aborignal and/or Torres Strait Islander Primary Health Care (Clinical/Practice) Cert II	Aborignal and/or Torres Strait Islander Primary Health Care (Clinical/Practice) Cert III	Aborignal and/or Torres Strait Islander Primary Health Care (Clinical/Practice) Cert IV	Aborignal and/or Torres Strait Islander Primary Health Care (Clinical/Practice) Diploma	Aborignal and/or Torres Strait Islander Primary Health Care (Clinical/Practice) Adv Diploma	Aborignal and/or Torres Strait Islander Primary Health Care (Clinical/Practice) Bachelor degree	Aborignal and/or Torres Strait Islander Primary Health Care (Clinical/Practice) Masters degree
Aborignal and/or Torres Strait Islander Primary Health Care (Community)	Aborignal and/or Torres Strait Islander Primary Health Care (Community) Cert II	Aborignal and/or Torres Strait Islander Primary Health Care (Community) Cert III	Aborignal and/or Torres Strait Islander Primary Health Care (Community) Cert IV	Aborignal and/or Torres Strait Islander Primary Health Care (Community) Diploma	Aborignal and/or Torres Strait Islander Primary Health Care (Community) Adv Diploma	Aborignal and/or Torres Strait Islander Primary Health Care (Community) Bachelor degree	Aborignal and/or Torres Strait Islander Primary Health Care (Community) Masters degree
Aborignal and/or Torres Strait Islander Primary Health Care (other)	Aborignal and/or Torres Strait Islander Primary Health Care (other) Cert II	Aborignal and/or Torres Strait Islander Primary Health Care (other) Cert III	Aborignal and/or Torres Strait Islander Primary Health Care (other) Cert IV	Aborignal and/or Torres Strait Islander Primary Health Care (other) Diploma	Aborignal and/or Torres Strait Islander Primary Health Care (other) Adv Diploma	Aborignal and/or Torres Strait Islander Primary Health Care (other) Bachelor degree	Aborignal and/or Torres Strait Islander Primary Health Care (other) Masters degree
Other primary care qualification (not specifically Aboriginal or Torres Strait Islander)	Other primary care qualification (not specifically Aboriginal or Torres Strait Islander) Cert II	Other primary care qualification (not specifically Aboriginal or Torres Strait Islander) Cert III	Other primary care qualification (not specifically Aboriginal or Torres Strait Islander) Cert IV	Other primary care qualification (not specifically Aboriginal or Torres Strait Islander) Diploma	Other primary care qualification (not specifically Aboriginal or Torres Strait Islander) Adv Diploma	Other primary care qualification (not specifically Aboriginal or Torres Strait Islander) Bachelor degree	Other primary care qualification (not specifically Aboriginal or Torres Strait Islander) Masters degree
Drug & Alcohol (specific qualification)	Drug & Alcohol (specific qualification) Cert II	Drug & Alcohol (specific qualification) Cert III	Drug & Alcohol (specific qualification) Cert IV	Drug & Alcohol (specific qualification) Diploma	Drug & Alcohol (specific qualification) Adv Diploma	Drug & Alcohol (specific qualification) Bachelor degree	Drug & Alcohol (specific qualification) Masters degree
Mental health and wellbeing (specific qualification)	Mental health and wellbeing (specific qualification) Cert II	Mental health and wellbeing (specific qualification) Cert III	Mental health and wellbeing (specific qualification) Cert IV	Mental health and wellbeing (specific qualification) Diploma	Mental health and wellbeing (specific qualification) Adv Diploma	Mental health and wellbeing (specific qualification) Bachelor degree	Mental health and wellbeing (specific qualification) Masters degree
Sexual health	Sexual health Cert II	Sexual health Cert III	Sexual health Cert IV	Sexual health Diploma	Sexual health Adv Diploma	Sexual health Bachelor degree	Sexual health Masters degree
Aged care, disability and/or home care	Aged care, disability and/or home care Cert II	Aged care, disability and/or home care Cert III	Aged care, disability and/or home care Cert IV	Aged care, disability and/or home care Diploma	Aged care, disability and/or home care Adv Diploma	Aged care, disability and/or home care Bachelor degree	Aged care, disability and/or home care Masters degree
Nursing	Nursing Cert II	Nursing Cert III	Nursing Cert IV	Nursing Diploma	Nursing Adv Diploma	Nursing Bachelor degree	Nursing Masters degree
Medicine	Medicine Cert II	Medicine Cert III	Medicine Cert IV	Medicine Diploma	Medicine Adv Diploma	Medicine Bachelor degree	Medicine Masters degree
Other Allied Health	Other Allied Health Cert II	Other Allied Health Cert III	Other Allied Health Cert IV	Other Allied Health Diploma	Other Allied Health Adv Diploma	Other Allied Health Bachelor degree	Other Allied Health Masters degree
Management	Management Cert II	Management Cert III	Management Cert IV	Management Diploma	Management Adv Diploma	Management Bachelor degree	Management Masters degree
Non-health	Non-health Cert II	Non-health Cert III	Non-health Cert IV	Non-health Diploma	Non-health Adv Diploma	Non-health Bachelor degree	Non-health Masters degree
No qualification (any but no ticks in boxes above or below)	No qualification (any but no ticks in boxes above or below) Cert II	No qualification (any but no ticks in boxes above or below) Cert III	No qualification (any but no ticks in boxes above or below) Cert IV	No qualification (any but no ticks in boxes above or below) Diploma	No qualification (any but no ticks in boxes above or below) Adv Diploma	No qualification (any but no ticks in boxes above or below) Bachelor degree	No qualification (any but no ticks in boxes above or below) Masters degree
Other	Other Cert II	Other Cert III	Other Cert IV	Other Diploma	Other Adv Diploma	Other Bachelor degree	Other Masters degree
Not thinkning of upgrading (tick any box)	Not thinkning of upgrading (tick any box) Cert II	Not thinkning of upgrading (tick any box) Cert III	Not thinkning of upgrading (tick any box) Cert IV	Not thinkning of upgrading (tick any box) Diploma	Not thinkning of upgrading (tick any box) Adv Diploma	Not thinkning of upgrading (tick any box) Bachelor degree	Not thinkning of upgrading (tick any box) Masters degree

Other (please specify)