Application forms for Licences and Permits

All applicants must complete a Personal Information Form: Identification, Fitness and Probity (Word 1.6MB). If the licence or permit is to be issued to a partnership, each business partner must complete the personal information form. If the licence or permit is to be issued to a body corporate, each corporate officer (directors, company secretary, chief executive officer or general manager and chief financial officer) must complete the personal information form.

A responsible person must be nominated for each premises on the licence or permit. Each nominated responsible person must complete a Personal Information Form: Identification, Fitness and Probity (Word 1.6MB).

Please read the Guide to applying for a Licence or Permit (Word 600KB)

Ambulance Service

You need to fill in the Health Service Permit-Ambulance Service application form (Word 325KB) if you are a business and you want to purchase medicines because you are operating a service which provides ambulances and/or paramedical staff for emergency services, events, training or patient transfers.

Cosmetic procedure clinic

You need to fill in the Cosmetic Procedure Clinic application form (Word 273KB) if you are a business that wants to administer cosmetic injections. Please read the Cosmetic Procedure Clinic Guideline (Word 366KB) about who should apply for these type of permits.

First aid

You need to fill in the Health Service Permit - First Aid application form (Word 254KB) if you provide workplace first aid and want to purchase multiple packs of medicines, such as adrenaline autoinjectors and salbutamol inhalers, from a medicines wholesaler. If you only need one or two packs of these medicines, you can purchase them from a pharmacy without a permit. If you require prescription medicines for providing first aid services, you should engage the services of a medical practitioner or occupational health business and they will need to use the application form for a medical treatment permit.

Immunisation Service

You need to fill in the Health Service Permit - Immunisation Service application form (Word 307MB) if you are an immunisation provider and you want to purchase vaccines for use at specific sites or as part of a mobile service (such as a workplace).

Indent

You need to fill in the Indent Licence application form (Word 230KB) if you provide a sales brokerage service to supply medicines and poisons but do not take possession of medicines and poisons.

Industrial

You need to fill in the Industrial Poisons Permit application form (Word 269KB) if you are a business (including sole traders) and you want to purchase poisons for use in your business. This form is not for people who want to sell poisons in their business.

Medical/dental practice

You need to fill in the Health Service Permit - Medical/dental practice application form (Word 324KB) if you are a medical or dental practice, including private hospitals and day surgeries, and you want to purchase medicines for use at the practice. Please note: a permit is only required where you want to pool medicines for use by all practitioners.

Medical treatment

You need to fill in the Health Service Permit - Medical Treatment application form (Word 319KB) if you are a medical business and you want to purchase medicines for providing medical treatment services to third party sites (such as mining and resource industry sites).

New application (Word 319KB)
Amendment to existing permit (Word 326KB)

If there is a change to the ownership of the business a new application is required. If the licence or permit is to be changed in type between individual (on behalf of the business), partnership or corporate a new application is required.

Any changes involving persons responsible also require completion of the Personal Information Form: Identification, Fitness and Probity.

Changes may incur a fee.

Application form to change a Permit or Licence (Word 319KB)

You need to fill in this form to make changes to an existing licence or permit, such as changing the permit or licence holder or relocating the business.

Application form to change a Medical Treatment Permit (Word 326KB)

You need to fill in this form if you want to make changes to an existing medical treatment permit (for purchasing medicines as part of providing health services to mining and resource sites).

If you have a current licence or permit, a renewal form will be posted to you approximately two months before it is due to expire.

To renew your licence or permit you must return the completed and signed form to the Medicines and Poisons Regulation Branch and pay the renewal fee. Fees can be paid by BPay or BPOINT. BPOINT payments (external site) can be made using a Mastercard or Visa credit card.

If your current licence or permit has been lost or destroyed, a replacement copy can be supplied. A fee of $40 is payable. Please contact the Medicines and Poisons Regulation Branch to obtain an application form, which includes details of how to pay.