Edit, Download, and Sign the NCHRC Application Form - WA Health Department
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How do I fill this out?
To fill out the NCHRC application form, start by ensuring you have all personal identification ready. Carefully print all details in the designated blocks. Double-check for accuracy before submission.

How to fill out the NCHRC Application Form - WA Health Department?
1
Prepare necessary identification documents.
2
Complete all required fields accurately.
3
Attach any additional documentation if needed.
4
Review the entire form before submission.
5
Submit the form as per the provided instructions.
Who needs the NCHRC Application Form - WA Health Department?
1
Prospective employees in healthcare roles need this file.
2
Volunteers wishing to work in government-funded health services must complete this form.
3
Students on placements in healthcare settings are required to fill out this application.
4
Independent contractors providing services to the Department of Health need to apply.
5
Any individual whose position requires a criminal check is obliged to submit this form.
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Use editing tools to complete necessary fields or make corrections.
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Download the edited PDF for submission.

What are the instructions for submitting this form?
To submit the NCHRC application form, you can either send it via email or post it to the Department of Health at the specified address. Ensure that all required documents and fees are included with your application. Follow the guidelines on the form for fax submission if applicable.
What are the important dates for this form in 2024 and 2025?
Important dates for the NCHRC application process typically include the submission deadlines outlined by the Department of Health. Ensure you review any updates for 2024 and 2025 regarding application timelines. Stay informed about schedules to ensure timely processing of your application.

What is the purpose of this form?
The purpose of the NCHRC application form is to facilitate comprehensive screening of individuals seeking to work within the healthcare system in Western Australia. By conducting these background checks, WA Health aims to ensure the safety and protection of all clients by preventing individuals with serious criminal histories from obtaining roles in which they may pose a risk. This form is critical not only for employment screening but also for maintaining a trustworthy healthcare environment.

Tell me about this form and its components and fields line-by-line.

- 1. Surname: Applicant's current legal surname.
- 2. Given Names: Full names of the applicant.
- 3. Date of Birth: Applicant's date of birth in DD/MM/YYYY format.
- 4. Residential Address: Current residential address, excluding PO Box.
- 5. Contact Information: Telephone number and email address for communication.
- 6. Identification Details: Driver's licence, passport number, and other necessary ID.
- 7. Consent Declaration: Acknowledgment and consent for information disclosure.
What happens if I fail to submit this form?
If the NCHRC application form is not submitted, the applicant may be disqualified from the hiring process. The delay in submission can also result in missing out on potential job opportunities within the WA Health system.
- Employment Opportunity Loss: Not submitting the form may result in losing a chance for employment.
- Delayed Processing: Failure to submit promptly can lead to delays in background checks.
- Ineligibility for Positions: Without the form, applicants may be deemed ineligible for specific roles.
How do I know when to use this form?

- 1. Job Applications: Used by candidates applying for roles requiring background checks.
- 2. Volunteer Work: Necessary for those volunteering in health-related services.
- 3. Contractor Engagement: Required for contractors providing services to WA Health.
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How many points of identification do I need?
You need to provide identification totalling 100 points as specified in the form.
What happens if I don’t submit this form?
Failure to submit the form may result in losing a chance for employment.
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