Application for approval to prescribe medications - Human Services 2026

1. Click ‘Get Form’ to open it in the editor.
2. Begin by entering your personal details in the 'Applicant’s details' section. Select your title (Dr, Mr, Mrs, etc.) and fill in your family name, first given name, and second given name.
3. Provide your date of birth and sex by marking the appropriate boxes. Ensure you use a black or blue pen if filling out manually.
4. Enter your provider number in the designated field. This is essential for processing your application.
5. Fill in your personal contact details including postal address, email address, business phone number, mobile phone number, and fax number if applicable.
6. Review the privacy notice carefully to understand how your information will be used and protected.
7. Complete the declaration section by signing and dating the form to confirm that all information provided is accurate.

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