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NSW Education Standards Authority 2023 Disability Provisions Health Professional Information Form (Vision) Important information This form is used by the NSW Education Standards Authority (NESA) to
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Read the instructions carefully before filling out the form.
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Provide your personal information such as name, contact details, and date of birth.
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Include your professional qualifications, such as degrees and certifications.
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Include information about any specializations or areas of expertise.
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Mention any professional memberships or affiliations.
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Provide accurate and up-to-date contact information.
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Who needs health professional information form?

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Healthcare professionals, such as doctors, nurses, physiotherapists, and pharmacists, who are seeking employment or credentialing.
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Professional associations and societies that require information for membership registration and maintenance.
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The health professional information form is a document used to collect essential details about health professionals, including their credentials, practice information, and compliance with regulatory requirements.
Health professionals such as doctors, nurses, pharmacists, and other licensed practitioners are typically required to file the health professional information form as part of their licensing or regulatory obligations.
To fill out the health professional information form, complete the required fields with accurate and current information regarding your professional credentials, workplace, licensing details, and submit any necessary documentation as specified.
The purpose of the health professional information form is to ensure that health professionals are properly licensed, track their practice, and maintain regulatory compliance for public safety and quality of care.
Information that must be reported typically includes the health professional's full name, contact information, education and training background, license number, practice location, and any disciplinary actions or malpractice history.
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