New South Wales Repealed Regulations

This legislation has been repealed.

OPTOMETRISTS REGULATION 1995 - SCHEDULE 1

SCHEDULE 1 – Forms

Form 1

(Clause 7)

CERTIFICATE OF REGISTRATION

BOARD OF OPTOMETRICAL REGISTRATION

Certificate of Registration No.

This is to certify that, in accordance with the provisions of the Optometrists Act 1930 ,

was on theday of19registered as an optometrist.

Chairperson

Dated at Sydney, thisday of19

Registrar

Form 2

(Clause 13 (1))

APPLICATION FOR RESTORATION OF NAME TO THE REGISTER

OPTOMETRISTS ACT 1930

OPTOMETRISTS REGULATION 1995 (Cl. 13)

Application for restoration of name to the register

I hereby make application for my name to be restored to the register of optometrists. I enclose $220, being the fee (prescribed by clause 13 (1) (b) of the Optometrists Regulation 1995 ) to restore a name to the register.

The reasons for this application are as follows:

I further apply for waiver of (state part)of the fee on the following grounds: (Here state grounds for waiver)

Signed

Address

Date

Form 3

(Clause 17)

CERTIFICATE OF AUTHORISATION TO USE DRUGS IN THE PRACTICE OF OPTOMETRY

BOARD OF OPTOMETRICAL REGISTRATION

Certificate of Authorisation to use drugs in the practice of Optometry No.

This is to certify that, in accordance with the provisions of the Optometrists Act 1930 ,
, a registered optometrist, is authorised to use drugs in the practice of optometry under and in accordance with section 29A of the Act and the regulations made under the Act.

Chairperson

Dated at Sydney, thisday of19

Registrar