Orthoptics Australia Ltd

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Middle Name

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Date of Birth

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DECLARATION: I declare that I am currently AOB registered and will advise OA should this status change

Yes

Year of birth (YYYY)

Gender

Where did you hear about Orthoptics Australia

Are you of Aboriginal or Torres Strait Islander Origin? Please tick one option

Yes Aboriginal

Yes Torres Strait Islander

Yes both Aboriginal and Torres Strait Islander

No

Are you currently working in orthoptics?

Yes in a clinical role (either full time or part time)

Yes in a combined clinical and non-clinical role (eg research, administration, management, education, industry)

Yes in a non-clinical role (eg research, administration, management, education, industry)

No I am working in a different role outside eye care

Not currently working (eg retired, extended leave)

What is your total work hours per week including clinical and non-clinical work?

How many hours per week do you work in a clinical orthoptics role?

Area/s of practice (select all that apply)

Main area of practice - if you answered 'other' to previous question please provide details:

Which of the following best describes your work sector? (select all that apply)

Work sector - if you answered 'other' to previous question please provide details:

Please provide the postcode for your workplace(s). If more than one - separate by a comma (eg 3000,3001)

Do you work in a rural / regional setting?

Yes I undertake all my work in a rural or regional setting

Yes I spend part of my work time in a rural or regional setting each week

Yes I provide regular outreach services (eg fortnightly or monthly) in a rural/ regional setting

No

Qualifying degree in Orthoptics (this is the degree that qualified you to work as an orthoptist - does not include higher degrees)

Diploma of the Orthoptic Board of Australia (DOBA)

Diploma of Applied Science (Orthoptics)

Bachelor of Applied Science (Orthoptics)

Bachelor of Orthoptics

Bachelor of Health Science / Master of Clinical Vision Sciences

Bachelor of Health Science / Master of Orthoptics

Master of Orthoptics

Other (please detail in next question)

If you answered Other to Qualifying degree in Orthoptics, please provide detail:

Qualifying institution - institution at which your qualifying degree in Orthoptics was obtained

Cumberland College of Health Sciences (CCHS)

La Trobe University (LTU)

University of Sydney

University of Technology Sydney (UTS)

Other, please provide detail in next question

Qualifying institution - if you answered other, please provide details:

Year of Qualifying Degree Completion Note: this is the year your studies were completed NOT the year of your graduation ceremony

Have you completed any further degrees since your qualifying degree in Orthoptics?

Yes

No

If yes, please name the highest degree obtained?

I wish to contribute in an OA committee or representative position in 2025-2026

Yes

Not at this time

I already hold a committee or representative position with OA

I agree to OA's Terms and Conditions of membership and Privacy Policy

Yes

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The national peak body representing Australian Orthoptists

Graduate Year 1 (AOB registered)

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