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ASGR-40

20. Were your results from the above-mentioned English language examinations obtained in the past two years?

YES

*ASGR-40*

NO

You must attach evidence that you:

  • have actively maintained continuous practice and/or employment as an enrolled nurse, registered nurse or midwife, using English as the primary language of practice, in one of the recognised countries listed in question 18, and/or

  • have been continuously enrolled in a program of study taught and assessed in English and approved by the recognised nursing and/or midwifery regulatory body, in any of the recognised countries listed in question 18.

SECTION H: Consent and obligations

Before you sign and date this form, make sure that you have answered all of the relevant questions correctly and read the statements below. An incomplete form may delay processing and you may be asked to complete a new form. For more information, see the Information and definitions section of this form.

Consent

I consent to the Board and AHPRA making enquiries of, and exchanging information with, the authorities of any Australian state or territory, or other country, regarding my practice as a health practitioner or otherwise regarding matters relevant to this application. I authorise the Board to obtain my criminal history in Australia and overseas. I understand that:

  • a complete criminal history, including resolved and unresolved charges, spent convictions, and findings of guilt for which no conviction was recorded, will be released to the Board, and

  • information will be extracted from this form and used for the purpose of criminal history checking. This information may be used by Australian police services for law enforcement purposes including the investigation of any outstanding criminal offences.

I acknowledge that:

  • the Board may validate documents provided in support of this application as evidence of my identity, and

  • failure to complete all relevant sections of this application and to enclose all supporting documentation may result in this application not being accepted.

I undertake to comply with all relevant legislation and Board registration standards, codes and guidelines. I understand that personal information that I provide may be given to a third party for regulatory purposes, as authorised or required by the National Law. I confirm that I have read the privacy and confidentiality statement for this form. I declare that:

  • the above statements, and the documents provided in support of this application,

are true and correct, and

  • I am the person named in the attached documents.

I make this declaration in the knowledge that a false statement is grounds for the Board to refuse registration.

Signature of applicant

SIGN HERE

Name of applicant

Date

D D / MM / Y Y Y Y

Obligations of registered health practitioners

The National Law pt 7 div 11 sub-div 3 establishes the legislative obligations of registered health practitioners. A contravention of these obligations, as detailed at points 1, 2, 4, 5, 6 or 8 below does not constitute an offence but may constitute behaviour for which health, conduct or performance action may be taken by the Board. Registered health practitioners are also obligated to meet the requirements of their Board as established in registration standards, codes and guidelines.

Continuing professional development

1.

A registered health practitioner must undertake the continuing professional

development required by an approved registration standard for the health profession in which the practitioner is registered.

Professional indemnity insurance arrangements

  • 3.

    A National Board may, at any time by written notice, require a registered health practitioner registered by the Board to give the Board evidence of the appropriate professional indemnity insurance arrangements that are in force in relation to the practitioner’s practice of the profession.

  • 4.

    A registered health practitioner must not, without reasonable excuse, fail to comply with a written notice given to the practitioner under point 3 above.

Notice of certain events

  • 5.

    A registered health practitioner must, within 7 days after becoming aware that a relevant event has occurred in relation to the practitioner, give the National Board that registered the practitioner written notice of the event. Relevant event means—

    • a)

      the practitioner is charged, whether in a participating jurisdiction or elsewhere, with an offence punishable by 12 months imprisonment or more; or

    • b)

      the practitioner is convicted of or the subject of a finding of guilt for an offence, whether in a participating jurisdiction or elsewhere, punishable by imprisonment; or

    • c)

      appropriate professional indemnity insurance arrangements are no longer in place in relation to the practitioner’s practice of the profession; or

    • d)

      the practitioner’s right to practise at a hospital or another facility at which health services are provided is withdrawn or restricted because of the practitioner’s conduct, professional performance or health; or

    • e)

      the practitioner’s billing privileges are withdrawn or restricted under the Human Services (Medicare) Act 1973 (Cth) because of the practitioner’s conduct, professional performance or health; or

    • f)

      the practitioner’s authority under a law of a State or Territory to administer, obtain, possess, prescribe, sell, supply or use a scheduled medicine or class of scheduled medicines is cancelled or restricted; or

    • g)

      a complaint is made about the practitioner to the following entities—

      • (i)

        the chief executive officer under the Human Services (Medicare) Act 1973 (Cth);

      • (ii)

        an entity performing functions under the Health Insurance Act 1973 (Cth);

      • (iii)

        the Secretary within the meaning of the National Health Act 1953 (Cth);

      • (iv)

        the Secretary to the Department in which the Migration Act 1958 (Cth) is administered;

      • (v)

        another Commonwealth, State or Territory entity having functions relating to professional services provided by health practitioners or the regulation of health practitioners.

    • h)

      the practitioner’s registration under the law of another country that provides for the registration of health practitioners is suspended or cancelled or made subject to a condition or another restriction.

Change in principal place of practice, address or name

  • 6.

    A registered health practitioner must, within 30 days of any of the following changes happening, give the National Board that registered the practitioner written notice of the change and any evidence providing proof of the change required by the Board—

    • a)

      a change in the practitioner’s principal place of practice;

    • b)

      a change in the address provided by the registered health practitioner as the address the Board should use in corresponding with the practitioner;

    • c)

      a change in the practitioner’s name.

Employer’s details

  • 7.

    A National Board may, at any time by written notice given to a health practitioner registered by the Board, ask the practitioner to give the Board the following information—

    • a)

      information about whether the practitioner is employed by another entity;

    • b)

      if the practitioner is employed by another entity—

      • (i)

        the name of the practitioner’s employer; and

      • (ii)

        the address and other contact details of the practitioner’s employer.

  • 8.

    The registered health practitioner must not, without reasonable excuse, fail to comply with the notice.

2.

A registered health practitioner must not practise the health profession in which

the practitioner is registered unless appropriate professional indemnity insurance arrangements are in force in relation to the practitioner’s practice of the profession.

Effective from: 9 September 2014

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