Forms and brochures
Australian Childhood Immunisation Register
- Your child’s immunisation history can help you brochure [PDF, 483Kb]
- Your child’s immunisation history can help you brochure [RTF, 80Kb]
- 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, 149Kb]
- Discover the facts about organ and/or tissue donation [PDF, 1.0Mb]
- Discover the facts about organ and/or tissue donation [RTF, 43Kb]
- Online registration
Medicare
- Bank account details collection form [PDF, 135Kb]
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 benefit at the doctor's brochure [PDF, 1.3Mb]
- Claiming your Medicare benefit at the doctor's brochure [RTF, 235Kb]
- Lodge your Medicare claim online brochure [PDF, 233Kb]
- Lodge your Medicare claim online brochure [RTF, 16Kb]
- Medicare benefit tax statement form
- Medicare benefit tax statement brochure [PDF, 355Kb]
- Medicare benefit tax statement brochure [RTF, 86Kb]
- Medicare claim form [PDF, 318Kb]
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, 330Kb]
- Medicare claiming—grandparents and carers [RTF, 19Kb]
- 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, 241Kb]
- Medicare levy exemption certification form [PDF, 157Kb]
If you were a resident of a Reciprocal Health Care Agreement country prior to your arrival in Australia, have applied for permanent resident status (conditions apply), are a New Zealand citizen who is residing in Australia or a permanent resident visa holder you may be eligible for enrolment in the Medicare program, therefore ineligible to claim exemption from payment of the Medicare levy. - Medicare notification of deceased person form [PDF, 210Kb]
- Medicare your questions answered brochure [PDF, 460Kb]
- Medicare your questions answered brochure [RTF, 166Kb]
- Medicare two-way claim form [PDF, 144Kb]
Complete this form and a Medicare Claim form [PDF, 318Kb] to lodge a claim with Medicare Australia and your private health fund. This form can also be used to claim gap benefits from your private health fund for in-hospital and ancillary services. - Statutory Declaration for Enrolment
Medicare Safety Net
- Medicare Safety Net registration form [PDF, 151Kb]
- Medicare Safety Net amendment form [PDF, 111Kb]
- Medicare Safety Net 2012 brochure [PDF, 861Kb]
- Medicare Safety Net 2012 brochure [RTF, 111Kb]
- Medicare Safety Net Register online
Medicare Teen Dental Plan
- Medicare Teen Dental Plan brochure [PDF, 856Kb]
- Medicare Teen Dental Plan brochure [RTF, 63Kb]
- 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]
Federal Government 30% rebate
30% rebate claim form for use at Medicare
- Federal Government 30% Rebate Form [PDF, 158Kb]
Print this form, complete and return to Medicare Australia
OR - Federal Government 30% Rebate Form - can be completed in Adobe Reader [PDF, 274Kb]
Download this form, complete and email 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 [PDF, 317Kb]
- Voluntary Indigenous Identifier brochure [RTF, 14Kb]
Medicare and PBS claims information application and authority forms
Online Services
- Lodge your Medicare claim online brochure [PDF, 184Kb]
- Medicare Australia Online Services brochure [PDF, 138Kb]
- Medicare Australia Online Services brochure [RTF, 44Kb]
Service Charter
Pharmaceutical Benefits Scheme (PBS)
- PBS patient claim for refund form [PDF, 129Kb]
- Pharmaceutical Benefits Scheme 2012 brochure [PDF, 859Kb]
- Pharmaceutical Benefits Scheme 2012 brochure [RTF, 96Kb]
- PBS Safety Net amendment, replacement or supplementary card application [PDF, 125Kb]
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Last updated: 10 February, 2012