I am authorised to represent (name of proposed nominator), the proposed nominator of (name of main visa applicant), an applicant for temporary entry to Australia.
I am aware the entry to Australia of (name of the visa applicant who failed the health requirement) (if applicable, a family member of the above named applicant) is estimated to result in health care and community services costs of approximately $??????????????????.
I understand that the health requirement for granting a visa to (name of visa applicant who failed the health criterion) may be waived if the proposed nominator gives an acceptable undertaking to meet all costs related to the disease or condition.
Consequently,(name of proposed nominator) undertakes to meet all health care and community service costs related to the diseases or conditions that otherwise caused (name of visa applicant who failed the health criterion) not to satisfy visa health requirement.