Registration form

---

This is the registration page to join Western Sydney Diabetes wall on myINTERACT. If you are already a member of myINTERACT please click here

If you do not have a myINTERACT account, please complete the fields below for access to the Western Sydney Diabetes wall through myINTERACT. Once complete click REGISTER at the bottom of the page to submit.

First name Last name Email Phone number Practice/Organisation Practice contact number Practice address
Street number Street name Suburb/Town Postcode Position/Profession select one option General Practitioner Practice Nurse Community Nurse Dietitian Podiatrist Exercise physiologist Optometrist Psychologist Pharmacist Other