HI Service - application to amend details of a contracted service provider organisation record form (HW043)
Use this form to add or amend the record of a Contracted Service Provider (CSP) organisation within the Healtchare Identifiers (HI) Service.
You must ensure that the amendments made to a CSP organisation details do not deem the CSP organisation ineligible for ongoing use of a CSP registration number under the Healthcare Identifiers Act 2010.
This PDF is fillable. Download this form and complete it on your device, or print it and complete it by hand.
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Page last updated: 13 February 2019