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ASGR-40

*ASGR-40*

SECTION J: Checklist

Have the following items been attached or arranged, if required? Additional documentation

Attached

Question 6

Evidence of a change of name

Question 12

Certified copies of all documents that provide sufficient evidence of your identity

Question 13

Certified copies of your primary academic qualification and examinations/assessments mentioned within this form

Question 14

A separate sheet with an explanation of circumstances of your criminal history in Australia

Question 15

A separate sheet with an explanation of circumstances of your criminal history in another country

Question 17 Question 18

A separate sheet with details of your impairment and how it is managed Certified copy of your Academic Transcript or a certified copy of either a Certificate of Attainment (CoA)/Statements of

Question 19 Question 20

Attainment/Statements of Results or Result Notices (however described by your education provider) A certified copy of your Board-approved English language test result

Evidence that you have actively maintained continuous practice and/or employment as a enrolled nurse, registered nurse or midwife, using English as the primary language of practice, in one of the recognised countries

Question 20

Evidence that you 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

Payment

Application fee Registration fee If paying by cheque/money order/bank draft, your name and date of birth are written on the back

Information and definitions

CERTIFYING DOCUMENTS

DO NOT send original documents unless specified. Copies of documents provided in support of an application, or other purpose required by the National Law, must be certified as true copies of the original documents. Each and every certified document must:

  • be in English. If original documents are not in English, you must provide a certified copy of the original document and translation in accordance with AHPRA guidelines, which are available at www.ahpra.gov.au/registration/registration-process

  • be initialled on every page by the authorised officer. For a list of people authorised to certify documents, visit www.ahpra.gov.au/certify

  • be annotated on the last page as appropriate e.g. ‘I have sighted the original document and certify this to be a true copy of the original’ and signed by the authorised officer, and

  • list the name, date of certification, and contact phone number, and position number (if relevant) and have the stamp or seal of the authorised officer (if relevant) applied.

Certified copies will only be accepted in hard copy by mail or in person (not by fax, email, etc). Photocopies of previously certified documents will not be accepted. For more information, AHPRA’s guidelines for certifying documents can be found online at www. ahpra.gov.au/certify

CHANGE OF NAME

You must provide evidence of a change of name if you have ever been formally known by another name(s) or if any of the documentation that you are providing in support of your application is in another name(s).

Evidence must be a certified copy of one of the following documents:

  • Standard Marriage Certificate (ceremonial certificates will not be accepted)

  • Deed Poll

  • Change of Name Certificate

Faxed, scanned or emailed copies of certified documents will not be accepted.

CRIMINAL HISTORY

Criminal history is defined in the National Law as:

  • every conviction of the person for an offence, in a participating jurisdiction or elsewhere, and whether before or after the commencement of this Law,

  • every plea of guilty or finding of guilt by a court of the person for an offence, in a participating jurisdiction or elsewhere, and whether before or after the commencement of this Law and whether or not a conviction is recorded for the offence, and

  • every charge made against the person for an offence, in a participating jurisdiction

or elsewhere, and whether before or after the commencement of this Law.

Under the National Law, spent convictions legislation does not apply to criminal history disclosure requirements. Therefore, you must disclose your complete criminal history as detailed above, irrespective of the time that has lapsed since the charge was laid or

the guilty finding was made. Do not provide copies of a criminal history check. AHPRA will conduct a check on your behalf. The Board will decide whether a health practitioner’s criminal history is relevant by considering the factors outlined in the Board’s Criminal history registration standard, found online at www.nursingmidwiferyboard.gov.au/Registration-Standards

ENGLISH LANGUAGE SKILLS

To be eligible for registration you must be able to provide evidence of English language skills that meet the Board’s English language skills registration standard, which can be found at www.nursingmidwiferyboard.gov.au/Registration-Standards

IMPAIRMENT

Impairment means a physical or mental impairment, disability, condition, or disorder (including substance abuse or dependence) that detrimentally affects or is likely to detrimentally affect your capacity to practise the profession. The National Law requires you to declare any such impairments at the time of initial registration and renewal, including details of the impairment and how it is managed.

PRACTICE

Practice means any role, whether remunerated or not, in which the individual uses their skills and knowledge as a nurse or midwife. Practice is not restricted to the provision of direct clinical care. It also includes working in a direct non-clinical relationship with clients, working in management, administration, education, research, advisory, regulatory or policy development roles, and any other roles that impact on safe, effective delivery of services in the profession and/ or use their professional skills.

PROFESSIONAL INDEMNITY INSURANCE (PII)

You must not practise the profession unless you are covered by appropriate PII arrangements in accordance with the requirements of the Board. You may be covered by your own private cover, your Australian employer’s cover or another third party. You are accountable for ensuring that you have PII cover in place and for understanding the nature of that cover. For more information, view the registration standard and guideline for each profession online at www.nursingmidwiferyboard.gov.au/Registration- Standards

Effective from: 9 September 2014

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