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2/1548ME (Design date 04/16) - Page 2 © COMMONWEALTH OF AUSTRALIA, 2016

Step 2 – How to fill in this form

This form is available as a PDF file and can be completed onscreen, printed and mailed to the department or you can printa copy and use a black or blue pen, write neatly in Englishusing BLOCK LETTERS.

You will be required to select the appropriate purpose of your visit.

If you need more space to answer questions or wish toprovide additional relevant information, give details at Part J orattach a signed and dated sheet giving the required details.

Any alterations made on the form must be initialled and dated.

You will need to supply 2 recent passport-sized photographsof each person included in your application.

A travel agent or other representative may help you fillout the form, but you must sign i t. If unable to sign, aparent or guardian may sign on your behalf.

Step 3 – Making your visa application

Check if a Visa Application Charge is required.

Not all applications attract a charge. If a prescribed charge isapplicable, the application will not be valid unless paymenthas been received.If a charge is required, payment must accompany yourapplication. Payment of the charge does not guarantee thisapplication will be successful and is generally not refundable.

Method of paymentBefore making a payment outside Australia, please check withthe Australian Government office where you intend to lodge

your application as to what methods of payment andcurrencies they can accept and to whom the payment shouldbe made payable.

What happens next? Your application will be considered and you may be asked toprovide additional information to enable a decision to bemade.

If you want to change any details after you have made theapplication, or if you want to withdraw it, please contact theoffice where you made the application.

You should also advise the office if any of the information yougave in your application changes while your application isbeing considered.

You will be advised in writing whether your application hasbeen approved or not.

If your application is approved you will be advised that youhave been granted a subclass 602 visa.

If your application is refused, you will be given a reason for thedecision as well as information about your review rights.

Passport informationMost visa applicants will be required to hold a valid passportbefore they can be granted a visa. It is strongly recommendedthat the passport be valid for at least 6 months.

If you change your passport after you have been granted the visa you must notify the nearest Australian Visa Office or officeof the department.

If you do not provide us with the details of any new oradditional passport you use to travel to Australia, youmay experience significant delays at the airport andmay be denied permission to board your plane.

Do NOT send your passport with your visa application.

Provide with your visa application a certified copy of the pagefrom your passport showing your photo and details. We willadvise you if your application has been approved. Please keepa copy of the Visa Grant Notification in a safe place for yourreference.

Health requirements All applicants must meet Australia’s health requirements. Youand any family members included in this application may berequired to undergo a chest x-ray and medical examination inorder to meet the criteria for the grant of a subclass 602 visa.

Information on health examinations is available on thedepartment’s website www.border.gov.au/trav/visa/heal

Conditions Visa condition – 8101

If your visa application is approved, it will be subject tocondition 8101. Visa holders must not engage in work in

Australia.

Visa condition – 8201

If your visa application is approved, it will be subject tocondition 8201. Visa holders must not engage in any studies ortraining for more than 3 months while in Australia.

Visa condition – 8503

If your visa application is approved, it may be subject tocondition 8503. Visa holders will not, after entering Australia,be granted a substantive visa, other than a protection visa,

while they remain in Australia.

How to applyStep 1 – Check your passport

Make sure you have a passport which is valid for your periodof stay in Australia. It is strongly recommended that passportsbe valid for at least 6 months.

If you are already in Australia and are eligible to apply in Australia, check the expiry date of your current visa. If you canapply whilst in Australia, you should make your visaapplication before your current visa expires.

Note : If you already have a visa for travel to Australia and youare granted another visa, the first visa will cease.

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Important information about privacy Your personal information is protected by law, including the Privacy Act 1988 . Important information about the collection,use and disclosure (to other agencies and third parties,including overseas entities) of your personal information,including sensitive information, is contained in form 1442i

Privacy notice . Form 1442i is available from the department’s website www.border.gov.au/allforms/ or offices of thedepartment. You should ensure that you read and understandform 1442i before completing this form.

www.border.gov.auTelephone131 881 during business hoursin Australia to speak to an operator (recordedinformation available outside these hours).If you are outside Australia, please contactyour nearest Australian mission.

Home pageGeneral

enquiry line

Please keep these information pages for your reference

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Application for aMedical Treatment visa

Form

48ME

Part A –Your details

3Tick where applicable

Please use a pen, and write neatly in English using BLOCK LETTERS.PHOTOGRAPH

Please attach 2 recentphotographs of yourself

AND

each person included in your passport andtravelling with you.

Give the following details exactly as they appear in your passport

Make sure your passport is valid for the period of stay you are applying for.

Date of birth

1

Family name

Given names

Passport number

Country of passportNationality ofpassport holder

Date of issue

Date of expiry

Place of issue/ issuing authority

DAY MONTH YEAR

DAY MONTH YEAR

Sex Male Female

2 Place of birth

Town/city

State/province

Country

3 Relationship statusMarried

De facto

Engaged Divorced

Separated

Widowed

Never married orbeen in a de facto

relationship

4 Are you or have you been known by any other name?

(including name at birth, previous married names, aliases)

Give details

No

Yes

Note: If this visa is approved, your current visa may cease.

No

Yes

Do you currently hold an Australian visa?5

Give details

No

Yes

Do you hold an identity card or identity number issued to you by yourgovernment (eg. National identity card)(if applicable) ?

Note: If you are the holder of multiple identity numbers because youare a citizen of more than one country, you need to enter the identitynumber on the card from the country that you live in.

6

Family name

Given names

Type of document

Identity number

Country of issue

Of which countries are you a citizen?7

8 Usual country of residence

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12 Do you agree to the department communicating with you by emailand/or fax?

This may include receiving notification of the outcome of this application.

Note: We can communicate about this application more quickly using

email and/or fax.

Give details

No

Yes

Fax number

Email address

( ) ( )

COUNTRY CODE AREA CODE NUMBER

9

POSTCODE

Your current residential addressNote: A street address is required as a post office box address cannotbe accepted.

10 Address for correspondence(If the same as your residential address, write‘AS ABOVE’)

Country

POSTCODE

Country

11 Contact telephone numbers

Home ( ) ( )COUNTRY CODE AREA CODE NUMBER

Office ( ) ( )

Mobile/cell

13 Are you applying on the basis of being a secondary person (ie. memberof family unit) of a person who already holds a subclass 602 visa onthe basis of being 50 or over and unfit to depart Australia?

Family name

Given names

Give details of the person you intend to remain within Australia

No Yes

Male Female

Date of birthDAY MONTH YEAR

Sex

Passportnumber

Number of people included in this application?Include yourself and any children who are named on

your passport and will be travelling to Australia with you.

14

For what period do you wish to remain in Australia?15

Date tofromDAY MONTH YEAR DAY MONTH YEAR

A person who will be receiving an organ

A person who will be receiving an organ

A person who will attend amedical consultation

A person who will attend amedical consultation

A person who will be donating an organ

A person who will be donating an organ

A person who will be accompanying oneof the above people

A person who will be accompanying oneof the above people

16 I am applying as:(Tick one box only)

Go to Question 17

Go to Question 17

A person who will undergomedical treatment

A person who will undergomedical treatment

OFFSHORE

A citizen of Papua New Guinea residingin the Western Province

Go to Question 23

ONSHORE

A citizen of Papua New Guinea residing

in the Western Province

A person who is a member of the familyunit of the above person

A person who is 50 or over and hasbeen refused a permanent visa on

health grounds

A current Medical Treatment visa holder

who is requesting permission to studydue to exceptional circumstances

A Medical Treatment visa holder who isrequesting permission to work due to

exceptional circumstances

Go to Question 21

Go to Question 22

Go to Question 23

Go to Question 23

Go to Question 17

Go to Question 17

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Briefly describe the medical treatment in Australia you have arrangedand estimated cost

18

Attach your medical treatment plan to this form.

19

POSTAL CODE

Give details of the doctor in your home country who referred you for

treatment in Australia(if applicable) Name of doctor in your home country

Address

20

POSTCODE

Give details of the doctor and/or hospital in Australia who will beproviding you with medical treatment

Name of doctor and/or hospital in Australia

Address

For what period will you be under medical care while in Australia?17

Date tofromDAY MONTH YEAR DAY MONTH YEAR

Medical details

Work details

Foronshore applicants who are applying for permission to work ,please provide brief reasons for requesting permission to work

21

Study details

Foronshore applicants who are applying for permission to study ,please provide brief reasons for requesting permission to study

22

Go to Question 24

Go to Question 24

1.

Relationship to you

Family name

Given names

23 Do you have any close relatives in Australia?

Give details of each close relative in Australia

No

Yes

No YesPermanent resident of Australia?

POSTCODE

Address

Relatives in Australia

2.

Relationship to you

Family name

Given names

No YesPermanent resident of Australia?

POSTCODE

Address

If more than 2 close relatives, give details at Part J

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Children included

Include in this application allchildren included in your passportwho will be travelling to Australia with you .

Children under 18 years of age, travelling alone or without one or bothof their parents or legal guardians, require documents identifyingcustody and access arrangements from the non-accompanyingparent(s) or guardian(s) to travel to Australia.

If a child under 18 years of age is staying in Australia with someoneother than a parent, legal guardian or relative, a declaration signed by

the person responsible for that child in Australia, is required to becompleted. See form 1257Undertaking declaration .

24 Are there any children in your passport who will be travelling to Australia with you?

Give details of each child

No

Yes

2.

Relationship you

Family name

Given names


Sex Male Female

Country of birth

1. Family name

Given names


Sex Male Female

Country of birth

If more than 2 children, give details at Part J Attach a consent to travel statement where one or more custodialparents/guardians are not accompanying the dependent child.

25 Will any of the children listed above receive medical treatmentwhile in Australia?

Give details

No

Yes

Part B – Funding for stay All visitors to Australia must be able to demonstrate that they haveadequate funds to cover all costs associated with their visit. Providingevidence of funds with an application will often help expedite theprocessing of a visitor visa application. Examples include showingpersonal bank statements, pay slips, audited accounts, taxation records.

If someone else is offering to help meet the cost associated with yourvisit, they may be asked to provide evidence of their ability to providesuch support, including the nature of their relationship with you.

26 How will you be maintaining yourself financially while you are in Australia?

Using your own funds – give details

Someone else will be providing support – give details

Relationship to you

Family name

Given names

What support are they providing you?

POSTCODE

Address


Financial

Accommodation

Give detailsOther

Relationship you

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No

Yes

In the last 5 years, have you, or any other person included in thisapplication, visited or lived outside your country of passport for morethan 3 consecutive months?

Do not include time spent in Australia.

27

Country(s)1.

DAY MONTH YEAR

Full name

Date tofromDAY MONTH YEAR

Give details

Part C – Health details

Country(s)

2.

DAY MONTH YEAR

Full name


Country(s)

3.

DAY MONTH YEAR

Full name


If insufficient space, give details at Part J

28 Do you, or any other person included in this application, intend toenter a hospital or a health care facility (including nursing homes)while in Australia?

Give details

No

Yes

29 Do you, or any other person included in this application, intend towork as, or study to be, a doctor, dentist, nurse or paramedic duringyour stay in Australia?

Give details

No

Yes

30 Have you, or any other person included in this application:• ever had, or currently have, tuberculosis?• been in close contact with a family member that has active

tuberculosis?• ever had a chest x-ray which showed an abnormality?

Give details

No

Yes

31 During your proposed visit to Australia, do you, or any other personincluded in this application, expect to incur medical costs, or requiretreatment or medical follow up for:• blood disorder;• cancer;• heart disease;

• hepatitis B or C and/or liver disease;• HIV Infection, including AIDS;• kidney disease, including dialysis;• mental illness;• pregnancy;• respiratory disease that has required

hospital admission or oxygen therapy;• other?

Give details

No

Yes

32 Do you, or any other person included in this application, requireassistance with mobility or care due to a medical condition?

Give details

No

Yes

33 Have you, or any other person included in this application, undertakena health examination for an Australian visa in the last 12 months?

No

Yes Give details(including HAP ID if available)

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If you answered‘Yes’ to any of the questions at Question 34, you mustgive all the relevant details including dates

If insufficient space, give details at Part J

Part D – Character details34

No

No

Yes

Yes

No Yes

No YesNo Yes

No Yes

No Yes

No Yes

No Yes

Have you, or any person included in thisapplication, ever:

• been charged with any offence that is

currently awaiting legal action?• been convicted of an offence in any country

(including any conviction which is nowremoved from official records)?

• been the subject of an arrest warrant orInterpol notice?

• been found guilty of a sexually based offenceinvolving a child (including where noconviction was recorded)?

• been named on a sex offender register?

• been acquitted of any offence on the grounds

of unsoundness of mind or insanity?• been found by a court not fit to plead?

• been directly or indirectly involved in, orassociated with, activities which wouldrepresent a risk to national security in

Australia or any other country?

• been charged with, or indicted for: genocide,war crimes, crimes against humanity, torture,slavery, or any other crime that is otherwiseof a serious international concern?

• been associated with a person, group or

organisation that has been/is involved incriminal conduct?

• been associated with an organisationengaged in violence or engaged in acts ofviolence (including war, insurgency, freedomfighting, terrorism, protest) either overseas orin Australia?

• served in a military force, police force, statesponsored/private militia or intelligenceagency (including secret police)?

• undergone any military/paramilitary training,

been trained in weapons/explosives or in themanufacture of chemical/biological products?

• been involved in people smuggling or peopletrafficking offences?

• been removed, deported or excluded fromany country (including Australia)?

• overstayed a visa in any country (including Australia)?

• had any outstanding debts to the AustralianGovernment or any public authority in

Australia?

No Yes

No Yes

Answer the following questions to see if there is anything youmust declare about your character.

These questions apply to yourself and any children included inyour application.

No Yes

No Yes

No Yes

No Yes

No Yes

No Yes

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Please give details of the person who assisted you

No

Yes

35 Did you receive assistance in completing this form?

Part E – Assistance with this form

Go to Part F

Family name

Given names

Title: Mr Mrs Miss Ms Other

POSTCODE

Address

Telephone number or daytime contact

( ) ( )


Office hours

Mobile/cell

36 Is the person an agent registered with the Office of the Migration Agents Registration Authority (Office of the MARA)?

No

Yes Go to Part F

No

Yes

Go to Part F

No

37 Is the person/agent in Australia?

38 Did you pay the person/agent and/or give a gift for this assistance?

Yes

Part F – Options for receiving written communications

39 All written communications about this application should be sent to:(Tick one box only)

Myself

You should complete form 956A Appointment

or withdrawal of an authorised recipient

Authorised

recipient

Migration agent

Exempt person

Your migration agent/exempt person shouldcomplete form 956 Advice by a migrationagent/exempt person of providingimmigration assistance

OR

OR

OR

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Part G – Payment details40 IMPORTANT: You must refer to the department’s website atwww.border.gov.au/trav/visa/fees to complete this part of your

application. The website shows reference tables with the Visa Application Charges applicable to each visa subclass.

41

AUD

AUD

AUD

AUD

AUD

AUD

AUD

AUD

AUD

Visa subclass you are applying for

You must pay thetotal amount or your visa application will not be valid.Note: A second instalment of the Visa Application Charge must also bepaid before we can grant some visas.

Base Application Charge

Write the amount shown on the reference table for your visa subclass

Non-internet Application Charge (if applicable)

(1)

(2)

(3)

(4)

(5)

+

+

+

=

+

Additional Applicant Charge aged 18 years or over at the time your application is lodged

Additional Applicant Charge under 18 years of age at the time your application is lodged

Subsequent Temporary Application Charge (if applicable)

Total (1) + (2) + (3) + (4) + (5)

Total

X (multiplied by)

X (multiplied by)

X (multiplied by)

=

=

=

Write the amount shown on thereference table for your visa subclass

Write the amount shown on the

reference table for your visa subclass

Write the amount shown on thereference table for your visa subclass

Number of additional applicantsaged 18 years or over

Number of additional applicants

under 18 years of age

Number of applicants

Give details below

Bank cheque

Money order

Credit card

How will you pay your application charge?Note: A surcharge may apply to payments made by credit card. Further information is available fromwww.border.gov.au/trav/visa/fees/how-to-pay-for-an-application

If applyingin Australia , credit card is the preferred method of payment. If paying by bank cheque or money order please make payable to theDepartment of Immigration and Border Protection.If applyingoutside Australia , please check with the Australian Government office where you intend to lodge your application as to what methodsof payment and currencies they can accept and to whom the payment should be made payable.

MasterCard

American Express

Visa

Diners Club

JCB

Payment by(tick one box) Australian Dollars

AUD

Credit card number

:

: : : :MONTH

:

: : : : : : : : : : : : : : YEAR

Expiry date

Cardholder’s name

Address

POSTCODE

Signature ofcardholder

Credit card information will be used for charge paying purposes only.

As the cardholder I acknowledge and accept that a credit cardsurcharge may apply to the transaction.

Telephonenumber

( ) ( )


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Part H – Application checklist 42 Please attach the following documents to this application

(Keep a copy of the documents for your own records.)

If you are applying in Australia you must include theVisaApplication Charge

Attachevidence of your own funds

Attachstatements from any people or organisationswho will be providing you with financial assistance, suchas paying any of your costs, providing services free, ormaintaining you while you are in Australia

Attachwritten confirmation from the doctor orhospital who will be treating you in Australia, stating:• that they agree to treat you;• that satisfactory arrangements have been made for

the payment of all costs associated with thetreatment;

• the nature of the treatment;• the admission date (if applicable); • the period you will be under medical care in Australia;• no Australian citizen or permanent resident will be

disadvantaged in obtaining medical treatment.

If you will be receiving treatment in a public hospital in Australia, attachwritten approval from the hospital

If your visit is for an organ transplant, attachevidence that arrangements have been made for all the travel andexpenses of the donor, and that payment of these costswill not be a charge on Australia

If a child under 18 years of age will be travelling without

one or both parents/guardians, the non-accompanyingparent(s)/guardian(s) must provide documents identifyingcustody and access arrangements for the child to travelto Australia

If applying together with another person, yourapplications should beclipped together or placed in anenvelope Note: If anyone in Australia will be paying for your tickets, providing you

with funds, or maintaining you while you are in Australia, you may beasked to arrange for that person to send details about their financialposition to the visa office where you lodge your visa application.

You may have to fill out more forms or obtain certain reports or

documents to include in your application. The Australian Visa Office willtell you if this is necessary.

Identity page (showing photo and personal details)of your passport

Passport size photograph

Full birth certificate

To establishyour identity

Youmust provide:

Family Register Document

Identity card

Details of any name change (eg. by marriage ordeed poll)

Depending on your circumstances, youmay also be required to provide:

Identity page (showing photo and personal details)of their passport

Passport size photograph

Full birth certificate

To establish the identity ofchildren included in this application ,for each child

Youmust provide:

Family Register Document

Identity card

Details of any name change (eg. by deed poll)

Depending on their circumstances, youmay also be required to provide:

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I declare that:

• I have read and understood the information provided in thisapplication;

• I have provided complete and correct information in every detail onthis application, and on any attachments to it;

• I will inform the department in writing immediately as I becomeaware of a change in circumstances (including change of address)or if there is any change relating to information I have provided in orwith this application, while it is being considered;

• I understand that if any fraudulent documents or false or misleadinginformation has been provided with this application, or if I fail tosatisfy the Minister of my identity, my application may be refusedand I, and any other member of my family unit , may become unableto be granted a visa for specified periods of time;

• if documents are found to be fraudulent or information to be

incorrect after the grant of a visa, the visa may subsequently becancelled.

If a visa is granted, I understand that:

• I must abide by the conditions of the visa;

• if a ‘no further stay’ 8503 condition is imposed on this visa, it willlimit the ability to remain in Australia beyond the authorised periodof stay of the visa.

I have read the information contained in form 1442iPrivacy notice.

I understand the department may collect, use and disclose my personalinformation (including biometric information and other sensitiveinformation) as outlined in form 1442iPrivacy notice.

DECLARATION

WARNING: Giving false or misleading information or documents is aserious offence.

Before you sign the following declaration, you must read theConditionson page 2.

Signature ofapplicant

DateDAY MONTH YEAR

We strongly advise that you keep a copy of your applicationand all attachments for your records.

43

I consent to:

• the collection of my fingerprints and facial image.

I declare that:

• I understand that my fingerprints and facial image and mybiographical information held by the department may be given to Australian law enforcement agencies to help identify me, to helpdetermine my eligibility for grant of the visa I have applied for, andfor law enforcement purposes.

I consent to:

• Australian law enforcement agencies disclosing my biometric,biographical and criminal record information to the department forany of the purposes outlined above; and

• the department using the information obtained for the purposes ofthe Migration Act 1958 or the Australian Citizenship Act 2007.

BIOMETRICS DECLARATION AND CONSENT

This declaration and consent is for offshore visa applicants.

If I am requested or required to provide my fingerprints and facial image:

Part I – Signatures

Signature ofapplicant

DateDAY MONTH YEAR

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Part J – Additional information

Question number Additional information

If insufficient space, attach additional details.

Documents

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