VAD has been a legal end-of-life option for Victorians since June 2019, Western Australians since July 2021, and New Zealanders since 7th November, 2021. Tasmania, South Australia, and Queensland have all passed similar legislation and the New South Wales Parliament is currently debating their own Bill before voting. What specifically is VAD? Is it synonymous with assisted suicide? In the first two years, what has been the uptake of this practice amongst Victorian patients and their healthcare providers, and how does this compare to other jurisdictions in which assisted dying services are active? In this oral session, I present how I view the framework of assisted dying services and present data from the most recent VAD Review Board report of operations. I also present case series data from 344 patients who applied for VAD access to members of our statewide Community of Practice (CoP) that further elaborates on issues such as the diagnoses of VAD applicants, the reasons for which they apply, and explore any differences in palliative care involvement between metropolitan and rural applicants. 70% of applicants within the CoP dataset with a malignant diagnosis had gastrointestinal, thoracic, or genitourinary malignancies. Reasons for applying were multifactorial (median number of reasons = 4), and the most common reasons for applying were losing autonomy, being less able to engage in activities making life enjoyable, and loss of dignity (reported by 79%, 78%, and 71% of applicants, respectively). No significant difference in palliative care involvement was identified in patients from regional or rural areas, when compared to their metropolitan counterparts.