Gap Assessment Guidelines

Attachment C - Gap Assessment Selection Form

Page last updated: 02 November 2011

Organisation Name:

Address:
Contact Name and Position:
Contact Number:
Contact Email Address:

Please nominate which accreditation
framework/s is being sought:

Name of chosen Assessing Agencies/
Certification Bodies/Licence Providers:
1.
2. (If applicable)
3. (If applicable)
Please ensure that the quotes from Assessing Agencies/Certification Bodies/Licence Providers are attached to this form.
Specific needs or comments:





By signing this form you are committing to having a Gap Assessment conducted on your service by one of the above nominated Assessing Agency/Certification Body/Licence Provider and OATSIH’s funding requirements.

Signed by CEO:

Name:

Date:

Completed form and quote/s to be mailed. emailed or faxed to:
Attention: Quality and Accreditation Section
Department of Health and Ageing
MDP 652
OATSIH
GPO Box 9848
Canberra ACT 2601
OR
Email: OATSIHqualityenquiries@health.gov.au
OR
Fax: (02) 6289 5220
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