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Holroyd Private Hospital welcomes Visiting Medical Officers (VMOs) to apply for accreditation to our facility.  Please download the following form here.

Please include the following documentation when submitting your completed Schedule 5 Application for Appointment:

  • Current Curriculum Vitae
  • Photocopy of current AHPRA registration
  • Contact details for two referees
  • Hand Hygiene Certificate
  • Working With Children Check
  • Photocopy of current professional indemnity insurance certificate of currency showing:
    • Period of Insurance
    • Amount of Cover
    • Category of Insurance
    • Copy of Radiation License – if you intend to operate X-ray equipment.

Please return the completed application forms and supporting documents to the Hospital Director. Forms can be scanned and emailed or posted via regular mail or visit Contact Us for more information.

Please also familiarize yourself with our by-laws booklet By-Laws Booklet Sep 2016 pdf, responsibilities of the visiting medical officer in an emergency Responsibilities of the Visiting Medical officer in an Emergency 2017 and working with children check WWC Form.


To refer a patient to Holroyd Private Hospital, please complete the form here. For further information, please contact us on 02 9681 2222.