RPGP Emergency Mental Health Registration

Eligibility

To qualify for Emergency Mental Health grant funding, you must be registered for the Emergency Medicine component of the RPGP, and be responsible for providing care in respect of emergency mental health services/crisis intervention in patients presenting with acute mental health issues.

Title

Title:

First name: *

Last name: *

Email: *

Phone number: *

ACRRM membership number - if applicable:

Status

Select status: *

I am already registered for Emergency Medicine and wish to also register for additional Emergency Mental Health grant funding or

I am not currently registered for Emergency Medicine and wish to register for both Emergency Medicine and Emergency Mental Health grant funding

If you are registering for both Emergency Medicine and Emergency Medicine grant funding please also submit the current Rural Procedural Grants Program (RPGP) Application.

Please refer to RPGP guidelines for further information.

Evidence of providing Emergency Mental Health services

Attached evidence: *

I have attached a letter from my employer confirming that I am responsible for providing care in respect of emergency mental health services or crisis intervention in patients presenting with acute mental health issues in my current role or

I have completed and attached a statutory declaration confirming that I am responsible for providing care in respect of emergency mental health services or crisis intervention in patients presenting with acute mental health issues

If selecting the statutory declaration, please download and complete the Emergency Medicine Mental Health statutory declaration form and attach it here.

Evidence:

You are currently on:

Rural Procedural Grants Program (RPGP) Emergency Mental Health Registration

Eligibility

Status

Evidence of providing Emergency Mental Health services

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