PART 5 CLINICAL ENDORSEMENT AND CONSUMER – INFORMATION List all appropriate professional bodies / organisations representing the group(s) of health professionals who provide the service (please attach a statement of clinical relevance from each group nominated): Australian Society of Medical Imaging and Radiation Therapy Australian Diagnostic Imaging Association Australian and New Zealand College of Radiologists Australian and New Zealand Society for Geriatric Medicine Leading Age Services Australia (LASA): this body represents Aged Care service providers, and may reflect the importance of providing a mobile service to residents of aged care facilities. List any professional bodies / organisations that may be impacted by this medical service (i.e. those who provide the comparator service): As above, except LASA List the relevant consumer organisations relevant to the proposed medical service (please attach a letter of support for each consumer organisation nominated): None known List the relevant sponsor(s) and / or manufacturer(s) who produce similar products relevant to the proposed medical service: Not applicable Nominate two experts who could be approached about the proposed medical service and the current clinical management of the service(s): Name of expert 1: Insert name here Telephone number(s): Insert phone number/s here Email address: Insert email address here Justification of expertise: Insert a justification of expertise here Name of expert 2: Insert name here Telephone number(s): Insert phone number/s here Email address: Insert email address here Justification of expertise: Insert a justification of expertise here Please note that the Department may also consult with referrers, proceduralists and disease specialists to obtain their insight.
PART 5 – CLINICAL ENDORSEMENT AND CONSUMER INFORMATION List all appropriate professional bodies / organisations representing the group(s) of health professionals who provide the service (please attach a statement of clinical relevance from each group nominated): Australian Society of Medical Imaging and Radiation Therapy Australian Diagnostic Imaging Association Australian and New Zealand College of Radiologists Australian and New Zealand Society for Geriatric Medicine Leading Age Services Australia (LASA): this body represents Aged Care service providers, and may reflect the importance of providing a mobile service to residents of aged care facilities. List any professional bodies / organisations that may be impacted by this medical service (i.e. those who provide the comparator service): As above, except LASA List the relevant consumer organisations relevant to the proposed medical service (please attach a letter of support for each consumer organisation nominated): None known List the relevant sponsor(s) and / or manufacturer(s) who produce similar products relevant to the proposed medical service: Not applicable Nominate two experts who could be approached about the proposed medical service and the current clinical management of the service(s): Name of expert 1: Insert name here Telephone number(s): Insert phone number/s here Email address: Insert email address here Justification of expertise: Insert a justification of expertise here Name of expert 2: Insert name here Telephone number(s): Insert phone number/s here Email address: Insert email address here Justification of expertise: Insert a justification of expertise here Please note that the Department may also consult with referrers, proceduralists and disease specialists to obtain their insight.
1482_MSAC_Application_Form%20_Web_accessible.docx