Contractor Payroll Tax Declaration

Australian payroll tax rules require Next Healthcare to confirm how it works with the practices it pays. This short declaration (about 2 minutes) helps us correctly classify the payments made under your Service Agreement. It is a formal declaration, so please answer as accurately as you can.

Your details

Legal entity name *

ABN *

11 digits. We'll try to look up your registered name.

Contact person *

Email *

State (optional)

Practice type (optional)

A few questions about your practice

Other than Next Healthcare, does your practice ever send imaging out to another provider to be reported on? *

Even occasionally counts.

When your practice provides an imaging service, is more than one person involved across the steps? *

For example: preparing or positioning the patient, taking the image, entering patient details, or sending images to Next Healthcare. Count practitioners as well as admin or assistant staff.

Roughly what share of your practice's total annual income comes from Next Healthcare profit-share payments? *

Less than 25%25% – 50%50% – 75%More than 75%

Your best estimate is fine.

Declaration

I declare that the information provided is true and correct, that the services are provided by an independent business and not as an employee of Next Healthcare, that Next Healthcare will rely on this for payroll tax compliance, and that I will notify Next Healthcare if anything changes.

Authorised representative *

Position *

Date *