This sample text is for a letter from a registered medical practitioner certifying the gender of a sex and gender diverse applicant. This letter should be used for applicants who are intersex.

Registered medical practitioner’s letterhead

(including full name and contact details)

I, <medical practitioner’s full name> am the doctor of <name of patient> with whom I have a doctor/patient relationship and whom I have treated (or with whom I have a doctor/patient relationship and whose history I have reviewed and evaluated).

<Name of patient> is intersex and lives in the gender (specify new gender male or female).

OR

<Name of patient> is intersex and is of indeterminate sex.

Signature of medical practitioner

Signature block of medical practitioner

Registration number from the medical board of Australia (or equivalent overseas authority)