Public Health Risk Activity (Operator) Application Form

Type of Application*
- Application for Health Risk Activity Registration
- Application for Health Risk Activity Renewal
This field is hidden when viewing the form
Using QR Code?*
- Yes
- No
Applicant Details
Name*
First Last
Name
Address*
Street Address City State Post Code
Telephone*
Mobile Phone*
Email*
Date of Birth*
DD slash MM slash YYYY
ABN
Public Health Risk Activity Details
Please tick the applicable Public Health Risk Activities Performed*
- Body Piercing
- Ear Piercing
- Tattooing
- Permanent & Semi-Permanent Makeup
- Acupuncture
Competency training undertaken*
Upload Proof of training (Optional)
Drop files here or

Max. file size: 200 MB.

Applicant Details