Join the Hazel Team
Apply to become a Hazel Virtual Practitioner
Full Name
Email
Location
Select you specialty
Multiple selection allowed
General Practitioner
Sexologist / Sex Counsellor
Psycho-Sexologist
Psychologist
Traditional Chinese Medicine Practitioner
Other
If you chose other, can you please specify?
Please list all qualifications relevant to your specialty
Current practice or clinic details
What services can you provide to the Hazel patient community?
What is the cost of this service?
Are patients able to claim a medicare rebate for virtual consultations with your specialty?
If yes, please indicate rebate amount or item code
Why do you want to join Hazel?
How many hours can you provide per week?
We're looking for a minimum of 10 hours per week
Why do you think you are an ideal Hazel practitioner?
How did you hear about hazel?
Please upload your resume
Max 2MB
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