If you are interested in being a simulated patient, please fill in and submit the form below.
How would you rate your general health? *
Do you have a disability, impairment or long term medical condition?
If yes, please provide us with some information so we can we can arrange appropriate support and/or resources if required.
* Vehicle registration
Special dietary requirements
Main language spoken at home
** Previous acting or simulated patient experience:
* Curtin University is well serviced by public transport. However, if you require parking to attend a simulated patient session, please provide your vehicle registration number so parking fees can be pre-paid by Curtin Medical School. Please note, car parking availability can be limited and may be located some distance from the Curtin Medical School building, so plan your trip accordingly. If required, ACROD bays are located in close proximity to the Curtin Medical School building.
** Previous acting experience or experience acting as a simulated patient is not required. However, if you have any experience this can assist with our planning and scheduling for specific sessions.
Personal information collected is handled in accordance with the Australian Privacy Principles. Further information is available on Curtin University’s privacy webpage.