Public Employees Permit Application

About this form

This form is to be used to apply for a Public Employees Permit under the Medicines, Poisons and Therapeutic Goods Act 2008 (the Act).

Important information

  • The applicant should be familiar with the Act and the Medicines, Poisons and Therapeutic Goods Regulation 2008.
  • Failure to comply with ACT legislation renders a person liable to prosecution.
  • Information is collected for permit purposes and will not be provided to other parties without consent or unless otherwise required by law.


This form requires you to submit the following attachments (PDF is the preferred format):

  • One form of current photographic identification sighted and certified by an authorised witness. Please see identification requirements for important details on accepted documents.
  • Duty statements for each additional authorised person, if listed by position number.


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.