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 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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