What you need to open a medical practice in Australia

Before you sign9 min readReviewed 7 September 2026

Opening a practice is four projects running at once: a business, a building, a set of approvals, and a clinical operation. They have different timelines and only one of them is genuinely irreversible, which is the building.

This is the whole list, in the order that actually works.

1. The business, before anything is signed

• Structure and entity, decided with your accountant. It affects the lease, the loan and the tax treatment of the fitout.
• ABN, GST registration, and a business name if you trade under one.
• Professional indemnity and public liability. Your landlord will ask for evidence of the second before handover.
• Ahpra registration current for every practitioner, and any employer obligations if you are hiring rather than contracting.

2. The premises, which is the decision that sticks

Everything above can be restructured. A tenancy cannot. Before you sign anything, establish:

• Whether the use is permitted in that zone, and what level of approval it attracts. This differs by state and it is the single most common reason a good tenancy turns out to be the wrong one.
• Car parking, because the rate for a health care use is higher than for retail or office and a tenancy that satisfied it as a shop often does not as a practice.
• Shell condition, warm or cold, which moves the budget more than any finish you will ever choose.
• Accessible entry and an accessible WC under AS 1428.1. This rules out more tenancies than anything else on the list.
• Mechanical capacity, because consulting rooms carry higher air change rates than the office the plant was sized for.
• Make good, negotiated at heads of agreement while you still have leverage.

Our lease checklist is the long version of this, and site search and feasibility is what it looks like when someone does it properly.

3. Approvals, which set your opening date

Construction is predictable. Approvals are not, and they are what moves opening dates.

The pathway depends entirely on the state. New South Wales runs a complying development route or a full development application, then a construction certificate. Victoria separates the planning permit from the building permit and they happen in that order. Queensland assesses a material change of use as accepted, code assessable or impact assessable, and the difference between the last two is months.

Underneath all of them sits classification. A retail or office tenancy becoming a practice usually changes its building classification, and if procedures push it to Class 9a the construction requirements change with it.

4. Design to the standards that gate accreditation

This is the step most often left until too late. Accreditation is assessed against the building you built, so the time to satisfy it is at concept, not the month before a visit.

• The RACGP Standards for consulting room privacy, hand hygiene, secure storage of medicines and records, and treatment space.
• AS 1428.1 for the path of travel from the street to the consulting room, and the accessible sanitary facility.
• AS 1668.2 for mechanical ventilation rates by space type.
• AS/NZS 4815 or 4187 for instrument reprocessing, depending on what you actually do.
• Clean and dirty utility as separate rooms. Combining them is the most common finding raised against an existing practice.

5. Systems, before you need them

• Practice management software, and the hardware and cabling it assumes.
• Cold chain: a vaccine fridge with continuous monitoring on a dedicated circuit.
• Clinical waste and sharps contracts.
• Medicare and provider numbers, which have their own lead time.
• Policies and procedures, which accreditation asks for as documents rather than intentions.

6. The document that lets you open

A finished fitout is not permission to see patients. You need the occupancy certificate, or whatever your state calls it, and it depends on fire services commissioning, consultant sign-offs, essential safety measures and any conditions of consent. Every one of those involves somebody who is not your builder.

Book your opening date, your staff start dates and your first patients against that milestone rather than against practical completion. They are different things and they get confused constantly.

The order that works

Accountant and structure, then site search, then feasibility on a shortlist, then heads of agreement, then lease. Only then design, approvals, construction and the occupancy certificate.

The common failure is signing a lease first because a tenancy looked right, and then discovering what it costs to make it work. Everything on this list is recoverable except that.