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.
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 1 July 2009 (30kb, pdf)
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).
- complete an application to nominate a responsible person (amendment only; if needed)
- complete Part 5 of the Poisons Control Plan.
- 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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