Registration Form

Australian Health IT Capability Directory

An Australia - Taiwan ICT Cluster initiative
Supported By: Coordinated By:
*Required Fields

Company Details

  
Business/Trading Name *
Australian Business Number (ABN)
Website Address *
Comments/Company Description (75 words or less)
*

Street Address

  
Street Address Line 1
Street Address Line 2
Street Address Line 3
Suburb / City
Post Code / ZIP
State
Country

Postal Address

  
Postal Address Line 1
Postal Address Line 2
Postal Address Line 3
Suburb / City
Post Code / ZIP
State
Country

Contact Details

  
Role / Position *
Title *
Name *
Phone Number *
Fax Number
Mobile *
Email Address *

Demographics

  
Annual Turnover (AUD $)
Number of Employees
   

Categories

  
Tick the categories of products and services that your business can offer.
 

1. Intelligent Medical Devices

Active implantable devices
Cardiovascular
Diagnostics
Drug delivery devices
Laboratory equipment
Device Design and Development
Device Manufacture
Device Importer / Distributor
Patient Monitoring
Home Care
Intelligent Medical Device Hubs
   
 

2. RFID

Device Design and Development
Device Manufacture
Device Importer / Distributor
   
 

3. Healthcare Information and Communications Technology

Application Software:

Client Administration | Practice Management | Claiming
Clinical | Clinician Desktop¦Telemedicine ¦Chronic Disease Management
Specialist | Departmental | Emergency Department ¦Clinical Support Systems
Enterprise Management
Public Health | Surveillance
Transport | Accommodation | Environmental

Hardware:

Infrastructure | Communications

Services:

Technology | Infrastructure | Communications
Consulting Services
Government Services
Professional Services
Education | Research

Questions

  
  1. Current Products, Services, and Courses related to Health Information Technology (Please list those products, services, and courses that you provide specifically related to Healthcare & Life Sciences information technology, intelligent medical devices and automated radio-frequency-identification (RFID) tracking)
 
  2. Major Clients (Please provide a brief list of your major clients and their country)
 

Conditions of Registration

  
In proceeding with this registration you agree that the information you provide can be made available in the Australian Health IT Capability Directory. You also agree that in registering there is no obligation on the part of any organisation or personnel to contact you . You also agree that this registration does not imply any guarantee of work.
  I agree to the above terms *