Application form

Application for appointment as an accredited as an accredited practitioner – initial or re-accreditation

This form is to be completed in order to apply for an appointment as an accredited practitioner or to apply for re-accreditation.

Please ensure that you fill in all relevant information to the best of your ability. The form should take roughly 20 minutes to fill in fully. There is a save and continue button at the bottom of the screen should you be interrupted.

Before you begin, we advise that you have ready the following documents:

  • CV (please note your CV will be forwarded to the Medical Advisory & Audit Committee at the PMA Facility you are applying to, who will be asked to provide a recommendation regarding your application).
  • Copy of Post Graduate Qualifications
  • Copy of College Fellowship
  • Copy of certificate showing participation in Continued Medical Education
  • Copy of current Medical Defence Organisation Membership
  • Copy of current certificate of Medical Registration
  • Copy of AHPRA restrictions (if applicable)
  • 100 Point Identification Check (Copy of Passport or Birth Certificate – 70 Points and Driver’s Licence – 40 Points)

We also advise that you have a copy of the PMA Facility Rules open with you as you complete the application.