QCYCN membership registration form

Join the Queensland Child and Youth Clinical Network

Fill in the form below to register your interest in becoming a Queensland Child and Youth Clinical Network member.

Please include your given name and family name.
Professional stream *
Hospital and Health Service (if applicable) *
How did you hear about the Queensland Child and Youth Clinical Network? *

Privacy notice
  • We look after your personal information in line with the Information Privacy Act 2009.
  • The information you give us when you fill in the form will be kept safe. It will only be used to register your QCYCN membership. We won't share your data.
  • Read our privacy policy to learn more.

Security key


Can't read the security key? Click here to get a new key

Last updated: June 2024

Back to top