Request to remove your name from Medicare Australia's list of Recognised Fellows form (3124(ACT))

Use this form to request that the CEO of Medicare Australia removes your name from the list of 'Recognised Fellows'.

 

Page last updated: 8 June 2016

This information was printed Friday 30 September 2016 from humanservices.gov.au/health-professionals/forms/3124act It may not include all of the relevant information on this topic. Please consider any relevant site notices at humanservices.gov.au/siteinformation when using this material.