Commonwealth Consolidated Regulations

HEALTH INSURANCE REGULATIONS 1975 - SCHEDULE 1

Form 1         Application for approval as an organization under Part IV

(regulation 21)

HEALTH INSURANCE ACT

APPLICATION FOR APPROVAL AS AN ORGANIZATION UNDER PART IV

To: the Minister of State for Health.

                ( Name of applicant organization )

of                                              ,

                ( Address of applicant organization )

hereby makes application under subsection 40 (1) of the Health Insurance Act 1973 for approval as an organization under Part IV of that Act.

Dated this                          day of                             , 19        

( Signature of person authorized to

sign application )

( Position in organization )

Form 2         Application for approval of a health service

(regulation 22)

HEALTH INSURANCE ACT

APPLICATION FOR APPROVAL OF A HEALTH SERVICE

To: the Minister of State for Health.

      ( Name of applicant organization )

of                                              ,

      ( Address of applicant organization )

being an approved organization within the meaning of Part IV of the Health Insurance Act 1973 , hereby makes application under subsection 41 (1) for approval of the health service described in the Schedule, being a health service provided, or to be provided, by the organization.

SCHEDULE

( Here insert description of health service and address or addresses at which the service is to be provided .)

Dated this                       day of                             , 19

( Signature of person authorized to

sign application )

( Position in organization )