Allied Health Request Form

Western Victoria PHN (WVPHN) has a limited supply of surgical masks available for allied health professionals in our region who work in areas of high risk and where there is no available commercial supply. If you are employed by a General Practice, please contact your Practice Manager to identify whether masks have already been supplied to the practice.

Under directives from the Federal Government, WVPHN must consider the following when determining if it is a priority to supply masks to an allied health provider:

  • The likelihood of the worker having direct or close contact with high-risk patients who are presenting with fever and/or respiratory symptoms. For example: a respiratory physiotherapist working with patients with cough, sore throat and/or shortness of breath, as compared to an exercise physiologist who is likely to be working with well individuals
  • The extent to which the allied health professional can manipulate their environment or practice method to reduce the chance of transmission. For example: due to the nature of their work, a diagnostic radiographer cannot easily change their mode of practise or environment, whereas a dietitian or psychologist may be able to continue to provide services through telehealth.
  • The relative vulnerability of the patients that the allied health professionals are treating. For example: where the allied health professional is routinely treating patients who are immunocompromised, or those who are elderly or disabled.

Each practice should submit only one form and allied health professionals must use provided masks in line with the Government’s advice for appropriate use of PPE

  • Your details

  • Practice details

  • Types of allied health professionals who work at your clinic
  • Provide street address only. No post office box numbers.
Last modified: 21 July, 2020