CDU Menzies Medical Program

Simulation Participant Expression of Interest

Thank you for your interest in becoming a Simulation Participant (SP) at the CDU Menzies Medical Program (CMMP).

Simulation Participants support medical education by assisting medical students in practicing communication and clinical examination skills in a safe and supportive learning environment.

Please complete this short Expression of Interest form.

Submitting this form does not guarantee participation but allows our team to contact you when opportunities arise.

Your Details

First Name *

Last Name *

Preferred Name *

Email Address *

Phone Number *

Address *

Street address *Street address line 2

City *

State *

Postcode *

Country

Please upload a resume *

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Availability

Which days are you generally available? *

MondayTuesdayWednesdayThursdayFriday

Select all that apply

Mornings or Afternoon sessions *

MorningAfternoonAnytime

Consent

I confirm that the information provided is accurate and I consent to being contacted regarding the CMMP Simulation Participant Program. *

Signature *

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Date Signed *

Comments or Questions *

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CDU Menzies Medical Program

Simulation Participant Expression of Interest

Your Details

Availability

Other Questions

Consent