Diagnostic Imaging Accreditation Scheme
Registration

Practice Contact Details

General


Address of physical location of practice OR the physical location of the base where the mobile equipment is located*

Postal address    (Same as above )

Preferred Accreditation Contact

Practice Information










I am able to authorise and verify the information provided in respect to this application for accreditation.
I authorise NATA to verify the accuracy of the information provided in an application for accreditation by whatever means NATA sees fit.
I agree to:
  • notify NATA of significant changes to equipment, personnel or ownership of the LSPN within 28 days;
  • promptly pay all accreditation fees invoiced; and
  • be the primary contact at the LSPN for all accreditation related correspondence with NATA and the Department of Health.
I authorise NATA to store and use the information for the purposes of Division 5 of Part IIB of the HIA and the Legislative Instrument.
I am aware that giving false or misleading information is a serious offence.