Application in Respect of an Institution for Licence Authorising the Performance of Abortions 2025

1. Click ‘Get Form’ to open it in the editor.
2. Begin with Part 1: Applicant. Fill in your surname, first name, daytime contact phone number, mobile number, and email address. Ensure all information is accurate and printed in capital letters.
3. Move to Part 2: Institution. Enter your full name and address, stating your capacity in which you are applying. Select whether you are applying for a limited or full license and provide the institution's address.
4. In Part 3: Details of the institution, describe the facilities available at your institution, including patient accommodation, operating theatres, and staff qualifications. Clearly outline any existing institutions nearby and justify the need for your application.
5. Complete the counselling services section by detailing qualifications of counsellors and how confidentiality will be maintained during sessions.
6. Finally, in Part 4: Fees, ensure you enclose the application fee of $68.00. Sign and date the form before submission.

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