Department of Health (DoH) and
Tasmanian Health Service (THS)
Application for Assessed Disclosure under the
Right to Information Act 2009
The
Right to Information Act 2009 provides a framework for the disclosure of information held by public
authorities to the Tasmanian community.
1
When should I use this form?
The Department of Health (DoH) and Tasmanian Health Service (THS) makes information available to the
public in a variety of ways. The information that you are seeking may be available online or in the archives
office.
Assessed disclosure under the
Right to Information Act 2009 is the method of disclosure of last resort. You
should only use this form to apply for information that you believe is held by the public authority after you
have tried to obtain the information by other means. If the information that you are seeking is available
outside of the Act, we may reject your application.
Applications for assessed disclosure must be in writing and include the information required by
Regulation 5 of the
Right to Information Regulations 2021. It is preferable to use this application form, as it
will ensure that you provide all the information required to process your application and assist DoH/THS in
responding to your request.
2
Do I need to pay a fee when I make an application?
Section 16 of the Act provides that all applications for assessed disclosure of information must be
accompanied by an application fee. The application fee is 25 fee units, which is $41.25 for 2021-22 and is
indexed annually. The fee may be paid by cheque or money order made out to the Department of Health.
You can apply, using this form, to have the fee waived by DoH/THS if:
(a)
you have financial hardship (e.g. you hold a valid concession card)
(b)
you are a Member of the Tasmanian Parliament acting in connection with your official duty; or
(ba) the applicant is a journalist acting in connection with their professional duties; or
(c)
you can show that the information will be used for a purpose that is of general public interest or benefit.
3
What will happen when I lodge my application?
Before an application is accepted, we may need to contact you for further details to define your application.
We have 10 working days to do this. When an application is accepted, you will be notified via email
(or post if you do not have access to email). You will generally receive a decision in relation to your
application within 20 working days of it being accepted. We may request an extension for the time we have
to prepare and make a decision if we feel it will take longer than 20 days. This will be in agreement with
you.
If we do not make a decision within the time limits set out in the Act (or the time as agreed with you), the
application may be deemed to be refused and you may apply to the Ombudsman for a review.
Important note: This information does not constitute legal advice. If more information is required, consult the relevant legislation or a legal
adviser, as necessary.
Disclaimer: While reasonable efforts have been made to ensure that the contents of this document are correct, the Crown
in Right of the State of Tasmania, its agencies and employees, do not accept responsibility for the accuracy or completeness of the contents, and is
not liable to any person in respect of anything or the consequences of anything done or omitted to be done in reliance upon the contents of this
document.
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Department of Health (DoH)
Tasmanian Health Service (THS)
Right to Information Act 2009
Application for Assessed Disclosure
Applicant’s Details:
Family Name:
Title:
Given Name/s:
DAY TIME CONTACT INFORMATION:
Email:
Postal
Address:
STATE:
POSTCODE:
Telephone:
Business
Home
Mobile
YES
NO
Application Fee ($41.25) included (please
OR
select)
Member of Parliament
Application for Waiver of Fee:
Financial Hardship*
Journalist
General Public Interest or Benefit**
* If claiming Financial Hardship, you must attach evidence that you are in receipt
of Centrelink or Veterans Affairs payments.
**If claiming public interest, you must show how the information will be used for
a purpose that is of general interest or benefit to the public.
Public
Interest:
For the release of your personal information, you must
Proof of identity provided:
provide photo identification or a copy of photo
identification which has been certified as a true copy by a
Justice of the Peace or a Commissioner for Declarations
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Details of efforts made prior to this application to obtain this information:
This information will help us to locate the information you are looking for.
Information Request: To enable the Department to identify the information in its possession,
please clearly outline your request below, or attach a separate sheet where necessary.
(1) What is the subject matter of the information you are seeking?
(2) What time period / date range would you like us to search within?
(3) Are there any other details that would assist us in locating the information you are seeking?
Applicant’s
Date:
Signature:
Privacy Statement
The Department of Health col ects personal information provided in this form for the purposes of processing your application for
assessed disclosure under the
Right to Information Act 2009. Personal information wil be managed in accordance with the
Personal
Information Protection Act 2004 and may be accessed by the individual to whom it relates on request to the Department.
Where should I send my application form?
You can address your application form to
Right to Information:
By Email: xxx@xxxxxx.xxx.xxx.xx
By Post: Department of Health, GPO Box 125, HOBART TAS 7001
If you have any questions or need assistance filling in this form please contact Legal Services
via email to xxx@xxxxxx.xxx.xxx.xx or phone: (03) 6166 3525
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