Private Health Regulatory Unit

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Application Requirements, Forms and Fees

Application Requirements (PDF, 143kB) | (Word, 2.1MB)

These documents are a guide for applicants to the type of information required by the Chief Health Officer to make a decision on whether to:

• Grant an approval
• Extend an approval
• Change an approval
• Issue a licence
• Renew a licence
• Change a licence
• Grant a prescribed alteration to a health facility service
• Transfer a licence.

Application Forms (Word, 3.73MB) | (PDF, 194kB)

The following are the forms associated with applications:

• Coversheet (Form A.1)
• Statutory Declaration (Form B)
• Statement of Parent Company (Form C)
• Statement Independent Financier / Accountant (Form D)
• Application for Approval (Form 8938.3)
• Application for a Change to an Approval (Form 89211.2)
• Application for Approval to Extend the Term of an Approval (Form 8936.2)
• Application for a Licence to Operate (Form 8935.3)
• Application for Renewal of a Private Health Facility Licence (Form 8937.3)
• Application for a Change to a Licence to Operate (Form 89212.2)
• Application for Approval of Prescribed Alteration (Form 891.3)
• Application for Transfer of a Private Health Facility Licence (Form 890.1)

Application Fees

Under the Act, fees may be charged for various matters relating to approvals and licences, for the replacement of approvals and licences (eg. that have been lost), and for applications to make a "prescribed alteration" under the Private Health Facilities Act 1999 s (63) of the Act.

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Clinical Service Capability Framework Templates

Clinical Service Capability Framework v3.0 and Clinical Service Capability Framework Companion Document v4.1 templates have been developed to assist applicants when submitting an application for the provision of a health service. These templates specify the service requirements, workforce requirements, support services and other requirements to ensure safe and appropriately supported health services.