Voluntary Assisted Dying Act 2022

Within 5 business days after deciding to accept or refuse the first request, the medical practitioner must—

complete the approved form (the first request form), and

give a copy of the first request form to the Board.

The first request form must include the following—

the patient’s name, date of birth and contact details,

the medical practitioner’s name and contact details,

the date the first request was made,

whether the first request was made in person or using audiovisual communication,

whether the first request was made verbally or in another way,

if the patient was assisted by an interpreter to make the first request—the interpreter’s name, contact details and accreditation details,

the medical practitioner’s decision to accept or refuse the first request,

if the medical practitioner’s decision is to refuse the first request—the reason for the refusal,

the date the medical practitioner informed the patient of the practitioner’s decision and gave the patient the information referred to in section 21(4)(b) or (5),

the medical practitioner’s signature and the date the form was signed.