Register your interest

To register your interest in participating, fill out the form below and click submit. Please make sure you include either a phone number or an email address that you can be contacted on.

To register please make sure you read the registration information before submitting the form.


 In registering my interest, I confirm that I have read the registration information

 

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  • In registering my interest, I confirm that:

    1.  I have read the information provided on this website regarding the Continuity of Care Experience ("COCE"), including the Frequently Asked Questions;


    2.  The information I have given is correct;


    3.  I consent to the University using my personal details (including health information)

    (a)  to assess whether I am eligible to participate in the COCE;

    (b)  to enable a University midwifery student to contact me to make arrangements for my participation in the COCE; and

    (c)   to establish the electronic database described in the Frequently Asked Questions.  My personal details will be removed from the database at the conclusion of the COCE.  Until my personal details are removed, they will be stored securely on the database and accessible to me upon request.  In that event, the University will either send me a copy of my personal details or discuss them with me over the telephone.   I may also contact the University to update or correct my personal details;


    4.  I understand that:

    (a)   if I do participate in the COCE, I will be provided with an additional form for completion, which indicates that I have agreed for the student to follow me through my pregnancy and birth experience;

    (b)   my participation in the COCE should not be taken as a substitute for, or as a directive against, the advice I obtain from my midwife or medical practitioners.  I am free to withdraw my participation in the COCE at any time;

    (c)    none of the information on this website is medical advice, which I should independently seek for my particular circumstances; and

    (d)   to the extent permitted by law, the information on this website is provided on an "as is" basis.  No warranty is given, whether express or implied, as to its accuracy or completeness.


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