Reference: Authority under section 56(6)  
                                              of the Nursing Act, 2005 (Act 33 of 2005) 
                                                                                
                                                                                
                                                                                
            
       
       
            
           AUTHORITY UNDER SECTION 56(6) OF THE NURSING ACT, 2005 (ACT 33 OF 2005) 
            
            
            
           …………………………………  
           (Name & address of Company) 
            
            
            
            
           Name of Nurse: ……………………………………………SANC Reg no. ………………………… 
            
           Name of Clinic: ………………………………………………………………………………………… 
            
           Address of Clinic: ………………………………………………………………………………………. 
            
           You are hereby authorised to diagnose and prescribe medicines for the conditions listed 
           in  the standing orders of the clinic according to the treatment protocols listed below, 
           subject to the limitations imposed by Section 56(6) and Section 61 of the Nursing Act, Act 
           33, 2005. 
            
           You  are  to  maintain  legible,  comprehensive  clinical  notes  in  the  patient  file  and  to 
           complete the medicine register/records as required in terms of the Medicines and Related 
           Substances Act (Act 101 of 1965) as amended. 
            
            
           Name of Medical Practitioner in charge: …………………………………………………………. 
            
           Address: …………………………………………………………………………………………………... 
            
           Tel: (……..) ……………………………………………. 
            
           Signed at ……………………………………….. on ………………. day of ………………………... 
            
           Signature: ……………………… Qualifications: …………………..HPCSA No: …………………. 
            
            
           Authorisation is effective as from ………............to ……………. (Recommend for duration of 
           contract i.e. 2 years) 
            
            
           PROTOCOLS                              MARK RELEVANT PROTOCOLS 
                 
            
              Family Planning                                     
              EPI (Extended Program for Immunisation)