For any assistance in completing this online Registration Form, please contact the AGPAL team by phoning 1300 362 111.

Please note: Credit card payment is required to complete the registration process online. If you do not wish to pay by credit card, please select the option "Invoice Me" at the end of this form.

A required item Indicates the form field is required to proceed.

Accreditation Contact Details

A required item  

Practice Details

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Are you currently accredited?
A required item  

If Yes, Please specify Expiry Date.

A required item  

Preferred method of receiving information:

Street Address

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Postal Address

Same as Street Address :

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Demographic Details

Is your practice considered a:

Other (Please specify):



Please select a Profession type a:
A required item  

Are you part of a corporate entity?

If Yes (please provide details):


In which Primary Health Network is your practice located?
A required item  

Accreditation Requirements

How did you find out about AGPAL Accreditation?

Other (please specify)

Practitioners(s)
Name of Practitioner Hrs per week Registrar VR    
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Self-Assessment Fee:

A self-assessment fee totalling $1200 (excluding G.S.T.) is now payable. This fee covers the cost of AGPAL’s client support, resources and online self-assessment tool provided to practices.

 
A required item  Please select one of the following
Pay Now
Invoice Me
Standards Option:

Please choose from the options below which edition of the RACGP Standards for general practices your practice is registering to be accredited against.

 
A required item  Please select one of the following
RACGP 5th Edition
Submission

, as the Accreditation Contact named in this Registration Form and authorised to act for and on behalf of the Practice, acknowledge that:-

A required item   I have read and accept the Terms and Conditions as contained in the Service Agreement.  

A required item   I have read the definition of the profession type being registered (general practice/medical deputising service/after hours service) and confirm the practice's eligibility to be accredited by AGPAL against the RACGP Standards AGPAL Accreditation - Definitions (GP, MDS, AH)

Please do not press submit button more than once.
If you experience any problems submitting, please contact AGPAL immediately on 1300 362 111.

Service Agreement

Service Agreement  size: 311 kb  Acrobat Document

AGPAL Accreditation - Definitions (GP, MDS, AH)

AGPAL Accreditation - Definitions (GP, MDS, AH)  size: 813 kb  Acrobat Document