Supporting documentation for applications
The following resources have been developed to assist with:
- providing evidence to support your applications - private hospital or day hospital
- changing details about executive staff or the authority holder.
Supporting documentation
- Accountant's financial statement (DOCX 571 kB)
- Alcohol and other drug services supporting documentation form (DOCX 114 kB)
- Bed and procedural areas form (DOCX 118 kB)
- Clinical services capability framework (CSCF) list of services and levels (DOCX 586 kB)
- Day-to-Day Manager and Nurse In Charge statement (DOCX 127 kB)
- Independent financial statement (DOCX 136 kB)
- Licence to operate supporting documents form (DOCX 133 kB)
- List of Directors, Board Members and Office Bearers (DOCX 118 kB)
- Mental health services supporting documents form (DOCX 118 kB)
- Parent company agreement (DOCX 577 kB)
- PHF Standards compliance self-assessment tool (DOCX 547 kB)
- Prescribed surgical services form (DOCX 116 kB)
- Prescribed alterations, operational approval supporting documents form (DOCX 123 kB)
- Proposed approval holder (authority holder) consent to release information (DOCX 120 kB)
- Statutory Declaration 2023 (DOCX 283 kB)
- Transfer of a licence supporting documents form (DOCX 126 kB)
Notifications
Building certifier referral - concurrency agency
Private Health Regulation Unit
Contact the Private Health Regulation Unit with any queries you may have regarding licensing:
Phone: (07) 3708 5325
Email: private_health@health.qld.gov.au