Medicare enrolment form (MS004)
Use this form to enrol in Medicare for the first time, re-enrol in Medicare or enrol your newborn child in Medicare. This replaces the 3101 version of the form.
Complete and return your form
- Open the Medicare enrolment form, fill it in, print and sign it.
- Submit your form and supporting documents to us. The instructions are on the 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: 31 July 2019