186Application for internal review of reviewable decision

186 Application for internal review of reviewable decision

186 Application for internal review of reviewable decision

An application for internal review under section 191 of the Law must include the following information—

(a) the name of the applicant;

(b) contact details for the applicant, including an address for service of the decision;

(c) the provider approval number or service approval number to which the reviewable decision relates;

(d) the full name of the person to whom the provider approval or service approval was granted;

(e) a statement setting out—

(i) the details of the decision or the part of the decision with respect to which review is sought;

(ii) how the decision affects the applicant;

(iii) the grounds for seeking a review of the decision;

(f) any information that the applicant considers relevant to the review.