OpenAthens Registration Form

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Register for an EPOCH OpenAthens account.

Use this form if you are NOT an employee of the Department of Health, Tasmanian Health Service, or Ambulance Tasmania.

Type of EPOCH User

State Service Staff

Visiting/Affiliated Practitioner

Visiting/Affiliated Student

Other

Personal Details

First Name

Last Name

Email Address

Name of your Organisation, Business or Academic Institution

Your email address affiliated with the Organisation, Business or Academic Institution

Your Email Address

Student Type

Type of Student

Student Year

What year of study are you completing?

Position/Placement Details

Region

Primary Role

Your role in the Department

Position Title

Name of Unit/Facility/Service

Contact Number for Unit/Facility/Service

Position Duration

Date of Departure (Month/Year)

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