Pre-application meeting request form

Before you submit this form, find out when you can request a pre-application meeting. The information you submit is covered by our privacy policy.

Your details

Name of individual or organisation requesting the meeting (mandatory)

Email address (mandatory)

Why are you requesting a meeting? (mandatory)

Will this be your first pre-application meeting for this application? (mandatory)

Yes

Lodgement date

When do you intend to lodge your MSAC application form?

Have you previously lodged an application for this service or technology?

Yes

Application number

Technology or service details

Name of the technology or service (mandatory)

Which patients would benefit from the technology or service?

Which practitioners would provide the technology or service?

What funding program are you applying for?

Please enter the funding program

TGA registration status

If applicable, what is the current Therapeutic Goods Administration (TGA) registration status of the product, device or medicine?

Other approval

If the technology or service involves a device or product that will need approval through another committee or process, please provide details. For example the Medical Devices and Human Tissue Advisory Committee (MDHTAC) or the Pharmaceutical Benefits Advisory Committee (PBAC).

Contact us

If you have any questions, please get in touch.

General enquiries

hta@health.gov.au

Last updated:

5 November 2024

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Pre-application meeting request form

Your details

Technology or service details

Contact us

General enquiries

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