Healthcare licences – policies and forms

All private licensed facilities:

• Additional services request form (PDF 135KB)
• Private hostel closure management process (PDF 537KB)
• Process for changes to a licence – policy (PDF 170KB)
• Ceasing to operate a licensed health facility (PDF 113KB)
• Ceasing to operate a licensed private psychiatric hostel (PDF 191KB)
• Ceasing to operate a licensed private psychiatric hostel – Form – Parts 1 and 2 (PDF 162KB)

• Notification of appointment – senior management - private hospitals, private day hospitals, private nursing homes and private nursing posts – form (PDF 108KB)
• Notification of appointment – senior management - private psychiatric hostel – form (PDF 61KB)
• Notification of appointment – director of nursing - private hospitals, private day hospitals, private nursing homes and private nursing posts – form (PDF 108KB)
• Notification of appointment – acting director of nursing - private hospitals, private day hospitals, private nursing homes and private nursing posts – form (PDF 97KB)
• Authorised delegate – form (PDF 241KB)

Private Hospitals and Private Day Hospitals (Class A)

• MP 0134/20 - National Safety and Quality Health Service Standards Accreditation Policy

Private hospitals, day hospitals (Class A, B, C and D) and nursing posts and nursing homes

SAC1 incidents

• Operational Directive MP 0122/19 Clinical Incident Management Policy 2019 (PDF 195KB)
• SAC 1 Clinical Incident Notification Form (PDF 94KB)

Critical/clinical incidents

• Critical/clinical incidents policy (PDF 72KB)
• Critical/clinical incidents form (PDF 266KB)  

Psychiatric hostels

Office of the Chief Psychiatrist

Notifiable clinical incidents:

• Notifiable incidents - psychiatric hostels - policy (external site)
• The Office of the Chief Psychiatrist notifiable incidents form (external site)

Laru critical/clinical incidents

• Critical/clinical incidents policy (PDF 72KB)
• Critical/clinical incidents form (Word 342KB)  

Private Hospitals and Private Day Hospitals (Class A, Class B, Class C and Class D):

• The Western Australian Review of Death Policy
• Death in hospital form (PDF 122KB)

• Admitted patient statistics-reporting procedure review (PDF 136KB)

• Independent Financial Certification – Financial Form (PDF 149KB)
• Licence Holder Financial Declaration  – Financial Form (PDF 143KB)

• Application for minor building works (PDF 288KB)
• Approval of the premises – Building approval process (PDF 218KB)
• Declaration for Minor Works at a Licenced Private Health Facility (PDF 45KB)
• 2021 Western Australia Health Facility Guidelines for Engineering Services (PDF 1MB)
• 2025 Western Australia Health Facility Guidelines for Engineering Services (PDF 3MB)
• WAHFG ES Declaration of Conformance Template (WORD 67KB)
• WAHFG ES Consultant’s Certification Template (WORD 32KB)
• WAHFG ES Installers Certification Template (WORD 32KB)
• WAHFG ES FAQ 2025 factsheet (PDF 178KB)

• Licence definitions of a bed policy and procedure (PDF 224KB)
• Maximum number of beds form (PDF 236KB)