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Your Name
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Salutation
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Mr.
Ms.
Mrs.
Dr.
Prof.
Mx.
First Name
Last Name
Email
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Mobile
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Registered with AHPRA?:
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Yes
No
Pending AHPRA
AHPRA Registration Number:
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Your AHPRA Number should be in the following format: 3 uppercase letters followed by 10 digits (e.g. DEN0001234567)
Registration Status:
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I’m a Dentist trained in NZ, UK, Canada or Ireland eligible for AHPRA registration
I trained as a Dentist overseas who is now ADC qualified (AHPRA pending)
I trained as a Dentist overseas. Not yet eligible for AHPRA registration
I’m a student Graduating from an Australian University (AHPRA pending)
Region
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All Gold Coast, QLD
Bairnsdale & Gippsland, VIC
Ballina, NSW
Bayside & Eastern Suburbs Brisbane, QLD
Bayside & South Eastern Suburbs Melbourne, VIC
Bendigo, VIC
Brisbane CBD & Inner Suburbs Brisbane, QLD
Canberra, ACT
Central Coast, NSW
Eastern Suburbs Melbourne, VIC
Eastern Suburbs, WA
Forster, NSW
Fremantle & Southern Suburbs, WA
Geelong, VIC
Goulburn, NSW
Melbourne CBD & Inner Suburbs Melbourne, VIC
Moreton Bay, QLD
Newcastle and Maitland, NSW
North Shore & Northern Beaches Sydney, NSW
North West & Hills District Sydney, NSW
Northern Suburbs & Joondalup, WA
Northern Suburbs Brisbane, QL
Northern Suburbs Melbourne, VIC
Nowra, NSW
Parramatta & Western Suburbs Sydney, NSW
Perth CBD, Inner & Western Suburbs, WA
Richmond & Hawkesbury, NS
Rockingham & Kwinana, WA
Ryde & Macquarie Park Sydney, NSW
South West & M5 Corridor Sydney, NSW
Southern Suburbs & Logan Brisbane, QLD
Southern Suburbs & Sutherland Shire Sydney, NSW
Sunshine Coast, QLD
Sydney CBD, Inner West and Eastern Suburbs, NSW
Tweed Heads, NSW
Upper Hunter and Cessnock, NSW
Wagga Wagga, NSW
West Gippsland & Latrobe Valley, VIC
Western Suburbs & Ipswich Brisbane, QLD
Western Suburbs Melbourne, VIC
Wollongong, Illawarra & South Coast
What interests you in joining Pacific Smiles Group?
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