Health Services Permit

This page contains all relevant forms and guides required to apply for a Health Services Permit, including a permit to generate standing orders.

To make an application you are required to:

• complete an application form for the permit.
• complete an application to nominate a responsible person.
• complete and maintain a Poisons Control Plan; where relevant, complete the Poison Control Plan module to Generate Standing Orders.
• pay the required fee.

Application processing time

After all completed documents and the relevant application fee are received, in most circumstances, a Department officer will contact the applicant to arrange an appointment to visit the premises to which the application relates, to ensure that there is capability to comply with legislative requirements.

The officer may identify deficiencies during the visit. If so, the application cannot proceed any further until documented evidence has been received by the Department that the deficiencies have been rectified.

From that time, it may take up to an additional six weeks for the application process to be completed.

Processing time may be reduced substantially if there are no document errors and any identified deficiencies are rectified promptly.

These forms need to be printed and forwarded to:

Manager, Drugs and Poisons Regulation Group
Department of Health
G.P.O. Box 4541
Melbourne Victoria 3001

Application for a permit

How to complete an application form (33kb, pdf)
Application for a permit to purchase or obtain poisons or controlled substances for use for the provision of health services (108kb, MS Word)

Application to nominate a person

How to nominate a responsible person (40kb, pdf)
Application form to nominate a responsible person (77kb, MS Word)

The application includes:

• How to complete an application to nominate a person
• Application to nominate a person to be responsible for maintenance of the poisons control plan
• Form to be completed by person to be nominated.

Fees

Table of Fees

Poisons control plan

Poisons control plan for a permit for the provision of health services:

Introduction and directions (52kb, pdf)
Part 1 (118kb, MS Word)
Part 2 (84kb, MS Word)
Part 3 (76kb, MS Word)
Part 4 (83kb, MS Word)


Part 1 - Sample answers (64kb, pdf)
Part 2 - Sample answers (30kb, pdf)
Part 3 - Sample answers (19kb, pdf)
Part 4 - Sample answers (25kb, pdf)

Modular Application for a Health Services Permit to Generate Standing Orders

This module contains Guidance on the process for Approval to Generate Standing Orders, the Generic Format for Standing Orders, and a copy of the Health Services Permit Condition for Generating Standing Orders.

This applies for an application to amend an existing Health Services Permit, or for a new application for a Health Services Permit.

Guidance on the Process for Approval to Generate Standing Orders (22kb, pdf)
Generic Format for Standing Orders (48kb, MS Word)
Condition included on permit to provide for use of standing orders in hospitals (21k, pdf)

To make an application you are required to:

• complete an application form (amendment).
  • see Application for a permit above.
    
    
• complete an application to nominate a responsible person (amendment only; if needed)
  • see Application to nominate a person above
    
    
• complete Part 5 of the Poisons Control Plan.
  • Part 5 (89kb, MS Word)
  • Part 5 - Sample answers (29kb, pdf)
    
    
• pay the required fee.

These forms need to be printed and forwarded to:

Manager, Drugs and Poisons Regulation Group
Department of Health
G.P.O. Box 4541
Melbourne Victoria 3001

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