Voluntary Assisted Dying Regulation 2025

the name and date of birth of the individual;

the name, business address and telephone number of the administering practitioner;

the date and time the approved substance was administered to the individual;

the address of the place where the administering practitioner administered the approved substance to the individual;

if the administering practitioner was present when the individual died—

the date and time of the individual’s death; and

the time between the substance being administered to the individual and the individual’s death;

if the administering practitioner was not present when the individual died—

the estimated time of the individual’s death; and

the estimated time between the substance being administered to the individual and the individual’s death;

details of any complications relating to the administration of the approved substance to the individual;

the name, date of birth, home address or business address and telephone number of the witness to the administration of the approved substance;

a statement, endorsed by the administering practitioner’s signature, acknowledging the truth of the information in the administering certificate;

the day the administering practitioner signed the administration certificate.