Start by selecting your answer from the first question below. The form will then request further information based on your inputs. Questions with a red flag are required to proceed with AGPAL registration.
*Please note that this form may not work within Internet Explorer, we recommend using a different browser to complete.
Step 1: Accreditation StatusPage 1 of 8
1
Status
2
Practice
3
Contacts
4
Address
5
Details
6
Staff
7
Payment
8
Submit
⚠ Required field — please make a selection.
✓
Thank you for re-registering with AGPAL.
As a current AGPAL client you are already registered and are not required to complete this form.
Simply contact a member of the AGPAL Client Liaison Team on
1300 362 111
to commence your re-accreditation.
⚠ Organisation name is required.
⚠ Expiry date is required.
⚠ Commencement date is required.
Please enter the date your practice began (or is expected to begin) operating.
AGPAL can only progress accreditation registrations for practices that are open
and operational at the time of registration.
ⓘ Please note
AGPAL can only progress accreditation registrations for practices that are open and operational at the time of registration. As your practice has not yet commenced operations, you may still submit your details; however, your registration will be held and processed closer to your opening date. An AGPAL team member will contact you with next steps.
PRACTICE INFORMATION
⚠ Practice name is required.
⚠ ABN is required.
⚠ Phone number is required.
⚠ Email address is required.
Only one email address please
⚠ Please select applicable standards.
PRACTICE CONTACTS
⚠ Contact first and last name are required.
Prefix
First Name
Last Name
⚠ Position is required.
⚠ Phone is required.
⚠ Email is required.
⚠ GP principal first and last name are required.
Prefix
First Name
Last Name
PRACTICE ADDRESS
⚠ Street address, city, state and postcode are required.
Address Line 1
Address Line 2
City
State
Postcode
⚠ Postal address fields are required.
Address Line 1
Address Line 2
City
State
Postcode
FURTHER PRACTICE DETAILS
⚠ Please select a PHN.
⚠ Please select a practice type.
⚠ Please make a selection.
Note: group discounts may be applicable.
⚠ Corporate entity / group name is required.
PRACTITIONER DETAILS
⚠ Please select the number of practitioners.
⚠ Please complete all practitioner fields.
Online Practitioner Registration Limit
Please note that we are only able to collect practitioner details for up to 10 practitioners via this online form.
As your organisation has more than 10 practitioners to register, please complete this registration form and make payment for the Self-Assessment fee. Following submission a member of the AGPAL Team will then be in touch to collect the necessary practitioner information and assist you with the next steps.
SELF ASSESSMENT FEE
Self-Assessment Fee:
A self-assessment fee totalling $1200 (excluding GST) is required to commence your
accreditation journey with AGPAL. This fee provides your practice access to AGPAL's Client Liaison Team
and your AGPAL accreditation hub, featuring resources and access to your online self-assessment tool, AccreditationPro.
Self-Assessment Fee:
A self-assessment fee, totalling $1200 (excluding GST), is required to commence your accreditation journey with AGPAL and will be issued once your practice is operational.
Client Services Agreement:
Click here to download a copy of the Client Services Agreement.
Definition of a General Practice for the purposes of accreditation:
Click here to download a copy of the Definition of a General Practice for the purposes of accreditation document.
⚠ Please select a payment method.
📋 What happens next?
When you click Next, a registration lead will be automatically created in our system with your practice details.
An AGPAL team member will be in touch to confirm your registration.
📋 What happens next?
When you complete the declaration on the next page and click Confirm and Submit, your details will be recorded in our system. As your practice has not yet commenced operations, an AGPAL team member will contact you closer to your opening date to proceed with registration and payment.
AUTHORISATION AND SUBMISSION
ⓘ Please note
AGPAL can only progress accreditation registrations for practices that are open and operational at the time of registration. As your practice has not yet commenced operations, you may still submit your details; however, your registration will be held and processed closer to your opening date. An AGPAL team member will contact you with next steps.
To avoid losing your form data if payment fails, we recommend selecting 'Save and return later' before proceeding to payment.
⚠ Please acknowledge the pending registration terms before submitting.
AGPAL Registration Fee
$1200.00
Credit card surcharge
$0.00
Goods and Services Tax (GST)
$0.00
TOTAL
$0.00
✓ Form Successfully Submitted
⚠ Please check all required boxes above before submitting.
🎉
Registration Submitted!
✓ Lead Record Created
Thank you - your registration has been received, and you will receive a confirmation email shortly. Please check your junk or spam folder if it does not arrive in your inbox. If you have any questions or need support, please don’t hesitate to contact the AGPAL team on 1300 362 111 or email info@agpal.com.au.
⌛ Registration Pending
Thank you - your submission has been received. You will receive a confirmation email shortly. Please check your junk or spam folder if it does not arrive in your inbox. As your practice is not yet operational, your registration is currently pending and a member of the AGPAL Client Liaison team will contact you closer to your opening date to progress your registration. If you have any questions or need support, please don’t hesitate to contact the AGPAL team on 1300 362 111 or email info@agpal.com.au.