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Online Form - Application for Skin Penetration Procedure Establishment

Regulation 6 of the Health (Skin Penetration Procedure) Regulations 1998

Premises Details

Hours of Operation

Type of premises

Proprietor Details

Select all procedures to be carried out on premises *

Food and Drink on Premises

Please indicate if food / drink will be prepared on the premises *



I/We declare that all details in this form are true and correct. Please be advised providing false information may be an offense.

An Assessment fee of $95 is applicable to this application.

I understand that I must submit a detailed site plan of the proposed premises including the following:

o Procedure area
o Hand washing facilities
o Work stations and preparation area
o Preparation area for refreshments
o Instruments and equipment storage area
o General waste and medical waste receptacles
o Laundry facilities
o Natural or mechanical ventilation