I am looking for a space form | South Western Sydney PHN

This free service is made available to GP practices and allied health professionals to foster interdisciplinary collaboration within South Western Sydney.

If you are an allied health professional, complete this form to advertise your interest to practise in a shared space.

About you

Your profession*

Your profession

Preferred locations (by Local Government Area)*

Bankstown LGA

Camden LGA

Campbelltown LGA

Fairfield LGA

Liverpool LGA

Wollondilly LGA

Wingecarribee LGA

Terms sought

Describe your preferred terms and days.

Snippet*

A brief description to appear on the listings summary page.

Requirement and amenities sought*

This is your main notice. Include as much information as possible. E.g. parking requirements, type of practice sought, room size and capacity.

Available from:

Estimated length of agreement

E.g. three months, one year, or ongoing.

Enter your preferred contact information for people to respond to your advert.

First name

Last name

Email

Phone

Advertiser details

The below information will not be viewed on the website. Provide this information for South Western Sydney PHN to contact you in relation to any admin or technical aspects of your request.

First name*

Last name*

Trading name

ABN

Email

Phone

Advert start date

Select a date in the future, allowing time for your request to be reviewed and published. If you leave this blank your notice will be published in approx. four business days.

Advert closing date*

Your advert will unpublish on midnight of the date you select

Consent*

I acknowledge and consent to the collection and use of my personal information in accordance with South Western Sydney PHN’s Privacy Policy. I also acknowledge that I am not sharing another person’s personal information without their informed consent. I understand SWSPHN takes my privacy seriously and will handle my data securely.