(choose as many roles as appropriate)
If you choose a role that is not appropriate to your current business role, your request will be declined and you will have to request access again.
Your date of birth will be kept confidential and is seen only by the RGS Administrator. It will be used for user identification purposes.
Address suggestion will be visible when you start typing your address.
This is the back-up email for the Security Code, and will not be published in the public user profile.
Please select the 'Yes' if you wish your profile to contain alternate contact information.
Please provide us with the contact details of a WA Health employee that can validate your request for access to the RGS. The person you nominate will be contacted to verify your status as a researcher intending to conduct research within WA Health.
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