Request for copyright permission

Title of NSW Health publication/resource/material to be reproduced *

SHPN (see inside front cover or footer) *

Provide the most recent publication date A precise day isn’t required - month and year are fine.

Page numbers

Provide a brief overview of the subject matter and end use of intended publication/resource *

First Name *

Last Name *

Phone *

Email address *

Organisation *

Conditions for the reproduction of NSW Health material

The materials specified must be reproduced in their entirety without further editing, except where this is clearly identified.
No responsibility or liability lies with NSW Health for any errors or omissions.
The NSW Health copyright material is only to be used for the purposes specified on this request form.
Where NSW Health copyright material is used in a publication, the NSW Ministry of Health must be provided with two copies of the publication when printed or provided with the URL.
By submitting this form you are accepting these conditions.