Voluntary Assisted Dying Act 2019

Within 2 business days after deciding to accept or refuse the referral, the medical practitioner must complete the approved form (the consultation referral form) and give a copy of it to the Board.

The consultation referral form must include the following —

the name, date of birth and contact details of the patient;

the name and contact details of the medical practitioner;

the date when the referral was received;

the medical practitioner’s decision to accept or refuse the referral;

if the medical practitioner’s decision is to refuse the referral, the reason for the refusal;

the date when the medical practitioner informed the patient and the coordinating practitioner for the patient of the practitioner’s decision;

the signature of the medical practitioner and the date when the form was signed.