Practice Incentives practice closure or withdrawal form (IP007)
Use this form to tell us you want to withdraw your practice, your practice branch has closed or you would like to withdraw from the PIP or the PNIP.
PIP is the Practice Incentives Program.
PNIP is the Practice Nurse Incentive Program.
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