MS-2 Step | User Registration Account InformationEmail Address* Enter Email Confirm Email It is recommended that you use a personal email address here. If you use a business email and then change employer you may be unable to administer your account at a later date (e.g. reset your password).Password* Enter Password Confirm Password Classification Type*Please selectGeneral PractitionerPharmacistFRANZCOGSexual Health PhysicianOther SpecialistOther Medical PractitionerMedical/Healthcare StudentNurse PractitionerAuthorised MidwifeOther Nurse/MidwifeAcademic/ResearchOther Healthcare ProfessionalSelect your University*Bond UniversityCharles Darwin UniversityCurtin UniversityDeakin UniversityFlinders UniversityJames Cook UniversityLa Trobe UniversityMacquarie UniversityMonash UniversityRMIT UniversitySwinburne University of TechnologyThe University of Western AustraliaUniversity of AdelaideUniversity of MelbourneUniversity of New South WalesUniversity of QueenslandUniversity of South AustraliaUniversity of SydneyUniversity of TasmaniaVictoria UniversityStudent ID number* Professional ID (AHPRA) Number*For example: Healthcare providers should enter their AHPRA registration number. Personal InformationTitle*Please selectMr.Mrs.Ms.Dr.A/Prof.Prof.Full Name* First Name Last Name Address and contact informationBusiness name For example: the name of your Practice / Pharmacy / College or Uni. If you are registering in a personal capacity, you may leave this optional field empty.Business phone numberBusiness address Suburb State*Please selectACTNSWNTQLDSATASVICWAPostcode* HiddenDeprecated field FRANZCOG or DRANZCOG Advanced prescribersYou have indicated that you have a Fellowship (FRANZCOG) or an Advanced Diploma (DRANZCOG Advanced) of the RANZCOG. Please upload a copy of your current RANZCOG certificate below.Max. file size: 127 MB.HiddenFRANZCOG or DRANZCOG Advanced prescribers Drop files here or Select files Accepted file types: jpg, jpeg, png, pdf, Max. file size: 20 MB, Max. files: 4. You have indicated that you have a Fellowship (FRANZCOG) or an Advanced Diploma (DRANZCOG Advanced) of the RANZCOG. MS Health requires the following as evidence of your current Fellowship (FRANZCOG) of the RANZCOG status: 1. A copy of your FRANZCOG certificate AND 2. A copy of your CPD compliance statement for the previous triennium and / or a Letter of Participation confirming your participation in the current CPD triennium. Please upload copies of these documents.HiddenPharmacy Account DetailsHiddenClifford Hallam Healthcare account number HiddenNational Pharmacies account number HiddenSymbion account number HiddenSigma account number HiddenAPI account number HiddenBarret Distributors account number If you have a Clifford Hallam Healthcare, National Pharmacies, Symbion, Sigma, API and/or Barret Distributors account, please insert your account number(s). This will enable Clifford Hallam Healthcare, National Pharmacies, Symbion, Sigma, API and/or Barret Distributors to better manage your account and ensure that you are able to order MS-2 Step (mifepristone, misoprostol) and the Mifepristone Linepharma 200mg tablet.AcknowledgementsBy agreeing to have my details go on the secure certified prescriber and dispenser list I am allowing only certified prescribers or dispensers to see my name to verify that my practice or pharmacy is MS-2 Step certified. If I do not tick this box, MS Health may not agree to validate me as an MS-2 Step certified prescriber or dispenser.* I have read and agree to the Terms and Conditions * I agree to MS Health collecting, using, holding and disclosing my personal information in accordance with the MS Health Privacy Policy Hidden I acknowledge that I have read the PBS listing information How did you hear about MS-2 Step?How did you hear about MS-2 Step?*Please selectMedia or news websiteMailInternet/Search engineConferenceProfessional publicationPeers/colleaguesMS Health representativeOtherOther EmailThis field is for validation purposes and should be left unchanged.
