| ( section 259 ) |
| In the [state district] Magistrates Court, Queensland |
| 1 I, [state name], police officer, of [address] make oath and say as
follows— |
| 2 [State name of the accused person] is in lawful custody on a charge(s) of
committing the offence(s) of [state offence e.g. by using the schedule form]. |
| 3 I have reasonable grounds for believing that— |
| *(a) a legally qualified medical practitioner doing a following act may afford evidence of the commission of the offence(s)— |
| *(i) examining the person of the accused person, including the orifices of the accused person’s body; |
| *(ii) taking samples of the accused person’s blood, saliva or hair; |
| *(iii) requiring the accused person to provide a sample of the accused person’s urine; |
| *(iv) collecting from the accused person’s person, including from the orifices of the accused person’s body, any substance or thing, the collection of which would be unlikely to cause bodily harm to the accused person if cooperation is given; |
| *(b) a legally qualified dentist doing a following act may afford evidence of the commission of the offence(s)— |
| *(i) examining the accused person’s mouth; |
| *(ii) taking samples of the accused person’s saliva; |
| *(iii) taking dental impressions from the accused person. |
| *[Cross out whichever does not apply]. |
| 4 The grounds for my belief are as follows [set out fully]— |
| 5 I have informed the accused person of his or her right to have present while
the act is being done 2 persons of the accused person’s choice. |
| 6 I apply for approval for the acts stated in this application to be done. |
| SWORN by the applicant |
| at [place] this day of [month and year] |
| before me |
| Justice of the peace |
| ( section 259 ) |
| In the [state district] Magistrates Court, Queensland. |
| I, [state name], stipendiary magistrate— |
| (a) am satisfied that— |
| (i) [state name], the accused person, is in lawful custody on a charge of committing the offence(s) of [state offence e.g. by using the schedule form]; and |
| (ii) there are reasonable grounds for believing that the doing of the acts mentioned in paragraphs (b) and (c) may afford evidence of the commission of the offence(s); and |
| (iii) the accused person has been informed of the accused person’s right to have present while the act is being done 2 persons of the accused person’s choice; and |
| *(b) approve the doing of the following acts by a legally qualified medical practitioner— |
| *(i) examining the person of the accused person, including the orifices of the accused person’s body; |
| *(ii) taking samples of the accused person’s blood, saliva or hair; |
| *(iii) requiring the accused person to provide a sample of the accused person’s urine; |
| *(iv) collecting from the accused person’s person, including from the orifices of the accused person’s body, any substance or thing, the collection of which would be unlikely to cause bodily harm to the accused person if cooperation is given; and |
| *(c) approve the doing of the following acts by a legally qualified dentist— |
| *(i) examining the accused person’s mouth; |
| *(ii) taking samples of the accused person’s saliva; |
| *(iii) taking dental impressions from the accused person. |
| *[Cross out whichever does not apply]. |
| |
| (Signed) Stipendiary magistrate |
| Date: |
| Place: |
| |
| Important notice |
| Before any of the acts mentioned in paragraphs (b) and (c) are done, the
accused person must be given a copy of this approval and informed of its
contents. |
Queensland Consolidated Regulations