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Application forms

Private Health Standards and Regulation

  • Application for Transfer of Licence for a Private Health Facility
  • Application for a Licence for Private Health Facility
  • Application for Alterations or Extensions to a Licensed Private Health Facility
  • Application for Amendment of Licence for a Private Health Facility
  • Application for a Licence to Supply Drugs of Addiction or Renewal of a Licence to Supply Drugs of Addiction or Transfer of Authority for the Handling and Storage of Drugs of Addiction

Other

  • 100 Point Identification Check
  • Fitness and Probity Check Form
  • National Criminal Record Check Consent Form
  • Statement by Independent Accountant Form
  • Statement of Parent Company Form
  • Statutory Declaration Form

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This web page is managed and authorised by Clinical Safety, Quality and Governance of the NSW Department of Health. Last updated: 22 August, 2011

  • Private Facilities

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  • Licensed facilities

  • Overnight facilities
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  • Drugs of Addiction facilities
 
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