Forms and brochures
Australian Childhood Immunisation Register
- Your child’s immunisation history can help you brochure [PDF, 1.6Mb]
- Your child’s immunisation history can help you brochure [RTF, 53Kb]
- Immunisation History form [PDF, 79Kb] – used to record a child's vaccination details that may be missing from the Immunisation Register. This form must be completed by a doctor or immunisation provider and sent to the Immunisation Register.
Note: printed copies of this form will not appear in triplicate.
- Medical Contraindication form [PDF, 137Kb] – used when a child cannot be immunised because of a medical condition. This form must be completed by a doctor or an immunisation provider and sent to the Immunisation Register.
- Conscientious Objection form [PDF, 131Kb] – used to record a parent's personal, philosophical, religious or medical belief that immunisation should not occur. This form must be signed by a doctor or immunisation provider and sent to the Immunisation Register.
Australian Organ Donor Registration
- New Registration or Change of Details form [PDF, 131Kb]
- Sign on to save lives brochure [PDF, 1.5Mb]
- Sign on to save lives brochure [RTF, 31Kb]
- Online registration
Medicare
- Bank account details collection form [PDF, 158Kb]
Complete this form to register your bank account details with Medicare Australia and claim your Medicare rebate at the doctor's or by EFT. - Claiming your Medicare rebate at the doctor's brochure [PDF, 1.5Mb]
- Claiming your Medicare rebate at the doctor's brochure [RTF, 25Kb]
- Medicare benefit tax statement form
- Medicare benefit tax statement brochure [PDF, 396Kb]
- Medicare benefit tax statement brochure [RTF, 61Kb]
- Medicare claim form [PDF, 190Kb]
Complete this form and send together with accounts/receipts, to Medicare GPO Box 9822 in your Capital City or take to any Medicare office. - Medicare claiming—grandparents and carers [PDF, 326Kb]
- Medicare Copy/Transfer Application form [PDF, 164Kb]
Complete this form to copy or transfer someone on to your own Medicare card or another Medicare card. Where the transfer or copy is to another person's Medicare card that cardholder must also sign the form. - Medicare enrolment and card forms [PDF, 257Kb]
- Medicare levy exemption certification form [PDF, 157Kb]
- Medicare notification of deceased person form [PDF, 210Kb]
- Medicare your questions answered brochure [PDF, 458Kb]
- Medicare your questions answered brochure [RTF, 136Kb]
- Medicare two-way claim form [PDF, 161Kb]
Complete this form to claim gap benefits from your private health fund for inpatient/ancillary services—private health fund claims can only be lodged by members of Funds participating in a two-way agency agreement with Medicare Australia. More information about Medicare two-way. - Statutory Declaration for Enrolment
Medicare Safety Net
- Medicare Safety Net registration form [PDF, 151Kb]
- Medicare Safety Net amendment form [PDF, 111Kb]
- Medicare Safety Net saving you money brochure [PDF, 388Kb]
- Medicare Safety Net saving you money brochure [RTF, 49Kb]
- Medicare Safety Net Register online
- How does the Medicare Safety Net work [PDF, 383Kb]
Medicare Teen Dental Plan
- Medicare Teen Dental Plan brochure [PDF, 315Kb]
- Medicare Teen Dental Plan brochure [RTF, 61Kb]
- Medicare Teen Dental Plan - Dental benefit claim form (DC1) [PDF, 222Kb]
Other programs and services
Compensation Recovery Program
- Compensation Recovery Electronic Funds Transfer (EFT) form [PDF, 156Kb]
- Compensation Recovery Electronic Funds Transfer (EFT) for Compensation Payers form [PDF, 116Kb]
- Compensation Recovery Medicare history statement request form [PDF, 73Kb]
- Notice of reimbursement arrangement form [PDF, 158Kb]
- Notice of judgment/settlement form [PDF, 238Kb]
- Third party authority [PDF, 185Kb]
- Section 23A statement form [PDF, 221Kb]
External Breast Prostheses Reimbursement Program
Federal Government 30% rebate
30% rebate claim form for use at Medicare
- Federal Government 30% Rebate Form [PDF, 103Kb]
Print this form, complete and return to Medicare Australia
Registration forms to receive the 30% rebate as a premium reduction
- Application to receive the Federal Government 30% Rebate as a reduced premium [PDF, 136Kb]
Print this form, complete and return to your private health fund
OR
- Application to receive the Federal Government 30% Rebate as a reduced premium - can be completed in Adobe Reader [PDF, 215Kb]
Download this form, complete and email to your private health fund
Indigenous
- Voluntary Indigenous Identifier brochure (Aboriginal) [PDF, 299Kb]
- Voluntary Indigenous Identifier brochure (Torres Strait Islander) [PDF, 274Kb]
Medicare Australia Access Points
- Medicare Australia Access Points brochure [PDF, 953Kb]
- Medicare Australia Access Points brochure [RTF, 42Kb]
Medicare and PBS claims information application and authority forms
Online Services
Service Charter
Pharmaceutical Benefits Scheme (PBS)
- PBS patient claim for refund form [PDF, 129Kb]
- Pharmaceutical Benefits Scheme – Your questions answered brochure [PDF, 338Kb]
- Pharmaceutical Benefits Scheme – Your questions answered brochure [RTF, 42Kb]
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Last updated: 18 March, 2010
