Health Care Facility New Licence Application
About this form
This form is to be used to apply for a health care facility activity licence under the ACT Health Care Facilities Code of Practice 2001, an enforceable Code of Practice under the Public Health Act 1997.
Health care facilities are premises where prescribed medical and dental procedures are carried out and/or premises in which overnight patient stays are provided prior to or after receiving medical treatment.
- One form of current photographic identification of each signatory must be provided, sighted and certified by an authorised witness. For details please see Identification requirements.
- For Company applications a copy of the company’s current extract (issued within the previous 30 days) from the Australian Securities and Investment Commission (ASIC). This can be obtained on the ASIC website.
- A floor plan showing the layout of all fixtures and fittings of the premises must accompany this application.
|Type of facility||Annual fee|
|Accredited facility (<200 beds)||$648|
|Accredited facility (>200 beds)||$1295|
|Sole dental practitioner||$259|
For more information, see Health care facilities licensing.
Payments up to $10,000 can be made with either Visa or MasterCard.
Your personal information
Access Canberra uses this form to collect information which is necessary to allow the ACT Government to provide services to you. Personal Information may be used or disclosed in accordance with the Information Privacy Act 2014.