Request to remove your name from a Recognised Fellows List form (HW068)

Use this form to request the removal of your name from the list of Recognised Royal Australian College of General Practitioners (RACGP) and / or Australian College of Rural and Remote Medicine (ACRRM) Fellows.

Download and complete the Request to remove your name from a Recognised Fellows List form.

This PDF is fillable. You can fill it out on your device, or print it and complete it by hand.

If you have a disability or impairment and use assistive technology, you may not be able to access our forms. If you can’t, please contact us. We can help you access, complete and submit them.

Page last updated: 20 February 2020