PIP Indigenous Health Incentive patient registration and consent form (IP017)

Use this form to register an eligible Indigenous patient in the PIP Indigenous Health Incentive or the Pharmaceutical Benefits Scheme (PBS) Co-payment Measure.

A practice or Indigenous health service participating in the Practice Incentives Program (PIP) Indigenous Health Incentive should complete this form.

This PDF is fillable. Download this form and complete it on your device, or print it and complete it by hand.

Page last updated: 20 October 2016

This information was printed Friday 28 October 2016 from humanservices.gov.au/health-professionals/forms/ip017 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.