*AFOI-001*
AFOI-00
Application for freedom of information
For documents under the Commonwealth Freedom 
of Information Act 1982
Please post this form and any attached documents to the following address as applicable. Indicate clearly on the envelope ‘FOI 
Application’ to allow for more efficient processing.
FOI request Queensland
FOI request for all other States and Territories Email: 
AHPRA  
AHPRA National Office
xxx@xxxxx.xxx.xx
FOI Application
FOI Application
GPO Box 9958
GPO Box 9958
Brisbane QLD 4001
Melbourne VIC 3001
Applicant details
Title 
First name 
Last name
SPECIFY
  The  Freedom of Information Act 1982 does not require an applicant to supply a contact phone number, but doing so will make it easier for an agency to 
consult you about your application.
Contact phone 
Email
Mailing address
Identification
  If you are seeking access to your personal information, please include  
Photo ID attached
YES 
 NO 
a photocopy of your passport, driver’s licence or other form of photo ID.
Legal representation or other party acting on behalf of the applicant
Company
Contact name 
Contact phone
  Authority to act attached
Provide a copy of the authority form to act on behalf of the applicant.
YES 
 NO 
I am applying for the following document(s):
  Give as much information as you can about the document(s) e.g. the file number or date of the document(s), if you have them, or describe as accurately  
as you can what the contents of the document(s) may be. If you are unsure about the details please contact the relevant state office. If the space below is 
insufficient, please attach a separate sheet with additional details.
  Documentation 
A hardcopy of the documentation to be released will be sent to the above mailing address. This may incur processing costs.
Privacy statement
We are authorised by the Freedom of Information Act to ask for the information on this 
and seek correction of your personal information held by National Law Entities; how to 
form. This information will be used to process your freedom of information application. 
complain to AHPRA about a breach of your privacy; and how your complaint will be dealt 
If you do not provide all information required on this form, this may result in your 
with. The policy can be accessed at www.ahpra.gov.au/About-AHPRA/Privacy.
application being delayed or refused. Where authorised to do so, AHPRA, the Advisory 
Council, the Agency Management Committee or a Board (‘National Law Entities’) may 
Date  D D / M M / Y Y Y Y
give this information to other bodies, such as the National Health Practitioners Privacy 
Commissioner and the National Health Practitioner Ombudsman. A National Law Entity 
Signature of applicant 
may be required under the Freedom of Information Act to give details about an FoI 
request to a person or organisation where the request is for information concerning their 
personal or business affairs (including medical or legal advice that person gave). 
SIGN HERE
The National Law Entities are committed to protecting your information in accordance 
with the Privacy Act 1988 (Cth). AHPRA’s privacy policy explains how you may: access 
Effective from: 1 December 2015 
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