Drug checking licensing scheme service delivery model amendment form

If a licensed provider wishes to use a service delivery model not on the approved list (Table 1 of the Ministry of Health drug checking webpage), or wishes to use a model not currently licensed for, they will need to satisfy the Director-General of Health (or delegated authority) that the model is safe to implement and fit for its intended purpose. Licensed providers must show that their workforce is competent to use a service delivery model before they will receive approval. New models can only be used by a licensed provider once written approval is received from the drug checking licensing team and the provider is licensed to do so.

Complete this form for any requested addition of drug checking service models to a provider’s licence.