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Department of Health - Australian Government

07/14/2020 | News release | Distributed by Public on 07/13/2020 17:33

Application to Provide Care in Respect of Provisionally Allocated Places Form

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Application to Provide Care Form

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Publication date:
March 2018
Last updated:
14 July 2020
Publication type:
Form
Intended audience:
Health sector
Description:

Please email the completed form and any attachments, with scanned copies of the endorsement page, to the state or territory office where the service is located.

The application may be submitted at any time before the end of the provisional allocation period.