Form 402

Application for approval for examination of a person in custody by legally qualified medical practitioner and/or legally qualified dentist

In force

(section 259)

In the [state district] Magistrates Court, Queensland

1 I, [state name], police officer, of [address] make oath and say as follows—

2 [State name of the accused person] is in lawful custody on a charge(s) of committing the offence(s) of [state offence e.g. by using the schedule form].

3 I have reasonable grounds for believing that—

*(a) a legally qualified medical practitioner doing a following act may afford evidence of the commission of the offence(s)—

*(i) examining the person of the accused person, including the orifices of the accused person’s body;

*(ii) taking samples of the accused person’s blood, saliva or hair;

*(iii) requiring the accused person to provide a sample of the accused person’s urine;

*(iv) collecting from the accused person’s person, including from the orifices of the accused person’s body, any substance or thing, the collection of which would be unlikely to cause bodily harm to the accused person if cooperation is given;

*(b) a legally qualified dentist doing a following act may afford evidence of the commission of the offence(s)—

*(i) examining the accused person’s mouth;

*(ii) taking samples of the accused person’s saliva;

*(iii) taking dental impressions from the accused person.

*[Cross out whichever does not apply].

4 The grounds for my belief are as follows [set out fully]—

5 I have informed the accused person of his or her right to have present while the act is being done 2 persons of the accused person’s choice.

6 I apply for approval for the acts stated in this application to be done.

SWORN by the applicant

at [place] this day of [month and year]

before me

Justice of the peace

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