Ramsay Health Service Library Self Registration

Please fill in all the details below. Items with a * are mandatory.

Branch	Hollywood Private Hospital Joondalup Health Campus *
Title	Mr Mrs Miss Ms Dr Prof
First Name	*
Surname	*
Home Address	*
Home Suburb	*
Home Postcode	*
Email	*
Work Phone	*
Mobile	*
Pager
Department	*
Position	*
Contract end date (if on contract)
Library Membership Agreement Please enter the confirmation code shown in the graphic below. By submitting this form I am agreeing to the following conditions. 1. Notify the Library of a change of address / phone number 2. Return books on time 3. Pay for any lost or damaged items