Health
Department of Health and Human Services

Forms

The following information provides guidelines for applicants for Assisted Reproductive Treatment in Victoria.

Child protection order check

Under section 11(1)(d) of the Assisted Reproductive Treatment Act 2008, a woman seeking assisted reproductive treatment and her partner (if applicable) must give permission to their Assisted Reproductive Treatment (ART) provider so that the provider can undertake relevant child protection order checks. Providers have a form that clients must complete giving this permission.

To ensure the provider can undertake a check of the woman and her partner (if applicable), each applicant must supply relevant details using the request for a child protection order check form (download from the link below).

The completed forms must be given to the provider for processing. Applications will not be accepted directly from individuals.

Note, that where treatment procedures are being carried out by a medical practitioner other than a doctor carrying out treatment on behalf of a registered ART provider, the permission must be given to the doctor in charge of the womans treatment. Refer section 11(2)(b) of the Act.

Note, the requirement to give permission for a child protection order check and the need for the details also applies to all parties to a surrogacy arrangement. Refer section 42 of the Act.

Assisted reproductive treatment child protection order checks: Information sheet 11 January 2010 (pdf, 28kb)

Assisted reproductive treatment child protection order checks: Guide to filling out the application form 11 January 2010 (pdf, 30kb)

Request for child protection order check form 11 January 2010 (pdf, 77kb)

Request for child protection order check extra details form 11 January 2010 (pdf, 39kb)

Criminal records check

Under the provisions of the Assisted Reproductive Treatment Act 2008, prior to a treatment procedure being undertaken, a woman and her partner (if any) must provide criminal record checks to the registered ART provider or in the case of treatment outside the clinic system to the doctor conducting the procedure.

A criminal record check means a statement prepared by a police officer that specifies -

  1. the police officer has checked records kept by the Victoria Police to determine whether the person has a criminal record; and
  2. details of the following:

    1. any convictions recorded against the person;
    2. any finding of guilt against the person, with or without conviction;
    3. any charges outstanding against the person;
    4. any other matters the member considers relevant.