Health Practice Closure, Merger or Relocation Online Form

You are required by the Health Records (Privacy and Access) Act 1997 to publicly advertise the closure, merger or relocation of your practice in a transfer notice 30 days prior to the closure, merger or relocation.

You are also required to notify ACT Health of the transfer notice information as soon as practicable after publication (please see the form below). ACT Health is required to forward this information to the ACT Health Services Commissioner.

If you are closing, merging or relocating a health practice, please complete this form.


1. Is the practice:   
2. If closing, merging or relocating a health practice, have you placed a public transfer notice of the closure, merger or relocation of the practice in the local newspaper?   
4. Where will health records be held?   


You have now completed the form. Please select the Submit button below. An automated copy of your form will be forwarded to the Health Services Commissioner.