Application for Approval to Supply Syringes

About this form

This form is to be used to apply for approval to supply syringes under the Public Health Act 1997.


If the applicant is a Health Worker a training certificate must be attached, showing completion of an approved course of instruction on appropriate health counselling and the hygenic distribution, use, collection and disposal of syringes as determined under Section 66B of the Act.


Health Protection Service

Phone: (02) 6205 1700

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.

For details on the collection of personal information in this form please refer to the Access Canberra Information Collection Notice. If you have questions about how your information will be handled please see the Access Canberra Privacy Policy and the ACT Health Privacy Notice or contact us.