Domestic violence declaration

Information for medical practitioners

As trusted professionals in the community, medical practitioners have an important role in assisting tenants to escape domestic violence under new laws starting on 28 February 2019.

You can declare that a tenant or their dependent child is a victim of domestic violence using one of the Medical Practitioner Declaration Forms below. The tenant can then use this form as evidence to end their tenancy without penalty.

This declaration is one of the four acceptable forms of evidence that a tenant can use to attach to their termination notice. Other forms of evidence are a Domestic Violence Order, family law injunction or a certificate of conviction. The declaration has been made available in response to concerns that many victims of domestic violence do not feel comfortable going to the police or engaging with the justice system.

You are not obliged to make a declaration.

Making a declaration

The declaration can only be completed by a medical practitioner, as defined under the Health Practitioner National Law (NSW). Medical practitioners must have consulted (in their professional capacity) with the tenant who is seeking to end their tenancy, or the tenant’s dependent child.

By signing a declaration, you are providing evidence that a tenant or their dependent child is a victim of domestic violence, based on your professional assessment.

You do not have to prove that an incident of domestic violence has taken place.

If you are not satisfied in your professional capacity that the tenant who is seeking to end their tenancy or the tenant’s dependent child is a victim of domestic violence, then you should not make a declaration.

It is an offence for a person to knowingly provide false or misleading information in connection with a declaration. It is also an offence for a person to sign the declaration knowing that it is false or misleading.

If the information you based your declaration on or which has been provided in the declaration is later found to be false or misleading, and you did not know this was the case at the time of making the declaration, then it is not an offence.

Declaration forms

If you are declaring that a tenant is the victim of domestic violence, complete the Medical practitioner declaration. A separate declaration needs to be made for each tenant seeking to be declared a victim of domestic violence.

If you are declaring that the tenant’s dependent child is the victim of domestic violence, complete the Medical practitioner declaration – dependent child. You only need to complete this form if the tenant is not a victim of domestic violence, but their dependent child is the victim.

It is important to read the information on the declaration form carefully and fill the entire form in.

Once you have made your assessment, you should complete this form by:

  1. entering the details of the tenant, and
  2. entering the name of the relevant domestic violence offender, based on the information provided to you by the tenant, and
  3. nominating the type of relationship between the tenant and the relevant domestic violence offender, based on the information provided to you by the tenant.

After making a declaration

After completing the declaration, give it to the tenant and keep a copy and any other notes, for your records. You are not required to take any further action.

The tenant must attach the signed declaration to a domestic violence termination notice and give these documents to their landlord or the landlord’s agent to end their tenancy.

Only the tenant’s landlord or the landlord’s agent will receive the declaration, which they must keep confidential and secure. The contents of a declaration are not reviewable in any Tribunal proceedings.

More information

More information on the domestic violence reforms is available on the Tenancy laws for victims of domestic violence webpage.

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