Practice Incentives practice ownership details and declaration form (IP008)

Use this form if you are applying for the Practice Incentives Program or the Practice Nurse Incentive Program through HPOS.

This information supports the practice ownership details you provide in your online application. You must provide the appropriate signatures on 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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