The South Australian
CICM Primary Exam Course

*** This Course is FULLY SUBSCRIBED ***
You may still register as a Reserve, should a position become available.

Registration Form: Course 11-15th May 2026

Applications open: October 1, 2025
All Fields (*) must be completed for acceptance.
*Surname :
*Firstname :
Preferred Name : (on Name-tag)
Hospital :
*Mobile / Phone :
Email :
 

NB: Microsoft (@msn.com, @outlook.com, @hotmail.com, @live.com) addresses get blocked by their email server - so please use an alternate email.
Gmail is OK as are all known Hospital and University email systems.
*State / NZ :
Faculty :
Dietery Requirements :
Emergency Contact :
Contact Mbl/Ph :
Afternoon viva sessions(*) - candidates can elect to attend either trial vivas, simulating the examination process, or small group tutorials:
Trial Vivas
Small group tutorials.

PLEASE NOTE:

  • Your position on the course is based upon clearance of payment by:
    • PayPal - a link will appear on confirmation of registration and in email, or
    • EFT / PayID - details provided in registration email
    • ** the order of clearance determines placement **
  • The Registration eMail may go to your SPAM folder - please check.
  • If you do not receive an email shortly or have other questions,
    please contact: Course Management
  SA Intensive Care Association