23Medical practitioner to notify Board of first request

#### 23 Medical practitioner to notify Board of first request 23 Medical practitioner to notify Board of first request > > (1) Within 5 business days after deciding to accept or refuse the first request, the medical practitioner must— > > > > > (a) complete the approved form (the first request form), and > > > > > (b) give a copy of the first request form to the Board. > > > (2) The first request form must include the following— > > > > > (a) the patient’s name, date of birth and contact details, > > > > > (b) the medical practitioner’s name and contact details, > > > > > (c) the date the first request was made, > > > > > (d) whether the first request was made in person or using audiovisual communication, > > > > > (e) whether the first request was made verbally or in another way, > > > > > (f) if the patient was assisted by an interpreter to make the first request—the interpreter’s name, contact details and accreditation details, > > > > > (g) the medical practitioner’s decision to accept or refuse the first request, > > > > > (h) if the medical practitioner’s decision is to refuse the first request—the reason for the refusal, > > > > > (i) the date the medical practitioner informed the patient of the practitioner’s decision and gave the patient the information referred to in section 21(4)(b) or (5), > > > > > (j) the medical practitioner’s signature and the date the form was signed.