Register or amend for Aged Care Online Claiming using web forms form (AC004)

Use this form to register for, or amend Aged Care Online Claiming using Web Forms if you are an approved residential or home care provider or service.

An authorised person of the approved residential and home care provider or service must complete and sign this form.

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

If you have a disability or impairment and use assistive technology, there are other ways you can do your business with us. You can use self service or request someone to deal with us on your behalf. If you can’t access our forms, please contact us. We can help you access, complete and submit them.

Page last updated: 14 November 2018

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