Online claiming provider agreement form (HW027)

Use this form to register for online claiming with us and the Department of Veterans' Affairs.

 
This PDF is fillable. Download this form and complete it on your device, or print it and complete it by hand.
This information was printed Tuesday 21 May 2019 from https://www.humanservices.gov.au/organisations/health-professionals/forms/hw027 It may not include all of the relevant information on this topic. Please consider any relevant site notices at https://www.humanservices.gov.au/individuals/site-notices when using this material.

Page last updated: 6 May 2019