Positron emission tomography - statutory declaration form (HW064)
Use this form to list the provider number and Location Specific Practice Number (LSPN) of the diagnostic imaging practice applying to perform PET services.
Download and complete the Positron emission tomography - statutory declaration.
PET is the Positron Emission Tomography.
This PDF is fillable. You can fill it out on your device, or print it and complete it by hand.
You can upload this form in HPOS.
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Page last updated: 10 August 2020
This information was printed 17 June 2021 from https://www.servicesaustralia.gov.au/organisations/health-professionals/forms/hw064. It may not include all of the relevant information on this topic. Please consider any relevant site notices at https://www.servicesaustralia.gov.au/individuals/site-notices when using this material.