Practice forms
Practice Forms
Find below a range of useful forms for General Practices. These links direct you directly to the original locations of the files to ensure you are accessing the most up to date version. Please report any errors or make suggestions for forms that should be included to web.admin@racgp.org.au
Quick Links
Practice infrastructure grants
Medicare Australia
Pharmaceutical Benefits Scheme
Australian Childhood Immunisation Register
Department of Veterans Affairs
Consumer Forms
RACGP application guide – general practice
infrastructure grants
The Australian Government’s Department of Health and Ageing
(DoHA) is offering primary care infrastructure grants to enable
existing general practices to expand or upgrade space for GPs, nurses,
and/or allied health professionals. Grants of up to $500 000 are open to
any eligible organisation or individual operating an existing general
practice, primary care or community health service, or Aboriginal
medical service. The College encourages interested and eligible
general practices to take advantage of this opportunity to apply.
Further details about the primary care infrastructure grants are
available at www.health.gov.au/tenders.
The College has developed a guide to assist RACGP members in preparing their applications for the primary care infrastructure grants. The primary purpose of the guide is to provide members with suggestions and examples of how they might approach the application form whilst highlighting key areas for consideration and available resources.
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Practice infrastructure
grants - RACGP application guide PDF 228Kb- Less than 1 minute to download on a 56K modem. |
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Practice infrastructure
grants - RACGP application guide PDF 113Kb- Less than 1 minute to download on a 56K modem. |
Application for Recognition as a GP (RACGP Fellows)
Since 1 November 1993, Fellows of the RACGP have been able to access
the
Group A1 attendance items (Items 3-51) in the Medicare Benefits
Schedule. These items, formerly reserved for Vocationally Registered
general practitioners, are to be called General Practitioner
Attendance
Items and may be used by medical practitioners on the Vocational
Register, Fellows of the RACGP, Registrars in general practice during
their general practice placement terms and Rural Other Medical
Practitioners. Fellows wishing to gain access to General Practice
Attendance Items must apply to HIC for recognition as a general
practitioner for purposes of Medicare.
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Application for Recognition as a GP
(RACGP
Fellows) PDF 379Kb- Less than 1 minute to download on a 56K modem. |
VR of GP's Certification of Eligibility
Apply to have your name included on the Vocational Register of General
Practitioners.
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VR of GP's Certification of
Eligibility PDF 379Kb - Less than 1 minute to download on a 56K modem. |
90 Day Pay Doctor Cheque Scheme Application Form
From July 2001, HIC will be able to automatically cancel Medicare
cheques made payable to an eligible General Practitioner via the
claimant when they remain unpresented after 90 days, and pay benefits
directly into GPs' financial institution accounts. Eligible GPs will
need to apply to HIC to register for the 90 Day Pay Doctor Cheque
Scheme.
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90 Day Pay Doctor Cheque Scheme
Application Form PDF 379Kb- Less than 1 minute to download on a 56K modem. |
Application for Late Lodgement of a Claim for Assigned Medicare
Benefits
Section 20B of the Health Insurance Act 1973 provides that Medicare
benefits are not payable where a claim is lodged outside certain
limits.
In the case of assigned Medicare benefits, a claim must be lodged with
the Health Insurance Commission within six(6) months of the date of a
professional service.
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Application for Late Lodgement of a Claim
for Assigned
Medicare Benefits PDF 379Kb- Less than 1 minute to download on a 56K modem. |
Application for Approval to Supply Pharmaceutical Benefits by a
Registered Medical Practitioner
A medical practitioner may be granted approval to supply
pharmaceutical
benefits in an area in which an approved pharmacist is unable to
supply
a convenient and efficient pharmaceutical service. In order to apply
for
such an approval in respect of an area in which you are currently
practising, or in which you intend to practise.
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Application for Approval to Supply Pharmaceutical
Benefits by a Registered Medical Practitioner PDF 379Kb- Less than 1 minute to download on a 56K modem. |
Application to Register as an Immunisation Provider Immunisation Providers must register with the ACIR before sending immunisation data. Public Sector providers must complete this form and forward it to their State/Territory Health Department for approval. General practitioners are automatically registered with the ACIR when they receive their Medicare Provider Number.
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Application to Register as an
Immunisation
Provider PDF 379Kb- Less than 1 minute to download on a 56K modem. |
Payment Account Details for Immunisation Providers
General practitioners must complete this form to receive payment for
immunisation data sent to the ACIR. Other immunisation providers may
update their bank account or credit union details recorded on the ACIR
using this form.
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Payment Account Details for Immunisation
Providers PDF 379Kb- Less than 1 minute to download on a 56K modem. |
NT, QLD and ACT Stationery Re-order Form Used by Northern Territory, Queensland and Australian Capital Territory immunisation providers to order immunisation stationery from the ACIR.
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NT and QLD Stationery Re-order
Form PDF 379Kb- Less than 1 minute to download on a 56K modem. |
Stationery Re-order Form
All States and Territories, excluding Northern Territory, Queensland and
Australian Capital Territory, should use this form to order immunisation
stationery.
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Stationery Re-order Form PDF 379Kb- Less than 1 minute to download on a 56K modem. |
Medical Contraindication Form
Used by recognised immunisation providers if there is a reason why a
vaccine should not be given to a child.
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Medical Contraindication Form PDF 151Kb- Less than 1 minute to download on a 56K modem. |
Conscientious Objection Form
Used to record a parent's conscientious objection to their child being
immunised. This form must be completed by a parent or guardian together
with the immunisation provider and sent to the ACIR.
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Conscientious Objection Form PDF 178Kb- Less than 1 minute to download on a 56K modem |
See the full list of Australian Childhood Immunisation Register (ACIR) forms for more.
All forms for the Department of Veteran's Affairs are available here. This includes the following:
Application for Refund or Payment of Privately Incurred Medical
Expenses (D1181)
Diagnostic Report - Anxiety Disorder or Depressive Disorder
(D0401)
Veterans1 Vocational Rehabilitation Scheme Application Form
(D1000)
Authority to Release Personal Information - Vietnam Veterans
Treatment of Depressive - Anxiety Disorder (D0400)
With the implementation of Statutory Registration it is no longer necessary for providers to complete forms D1065 – Application to be a Local Medical Officer or D1067 – Advice to new practice location – LMO. For further information see www.dva.gov.au/service_providers/doctors/lmo/Pages/lmo%20scheme.aspx
Medicare Enrolment Form Consumer Medicare Enrolment information.
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Medicare Enrolment Form PDF 21Kb- Less than 1 minute to download on a 56K modem. |
It is important to keep your Medicare address up to date. To update your information or or request for duplicate/replacement Medicare card (for example, if your card has or is about to expire) please see the range of options available to you.
Medicare Claim Form An online version of the form for claim and payment details.
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Medicare Claim Form PDF 15Kb- Less than 1 minute to download on a 56K modem. |
Medicare Safety Net Registration Form
Safety Net family registration/change form.
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Medicare Safety Net Registration Form PDF 50Kb- Less than 1 minute to download on a 56K modem. |
Medicare Copy/Transfer Application form
Form to request a duplicate copy of a Medicare card or transfer of
details from a current Medicare card to another Medicare card.
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Medicare Copy/Transfer Application form PDF 61Kb- Less than 1 minute to download on a 56K modem. |
Medicare Levy Exemption Certification Form
The Income Tax Assessment Act 1936 makes the Medicare Levy payable by
individuals residing in Australia who are eligible for Medicare.
Persons
who are not entitled to Medicare can seek an exemption to the Medicare
Levy in their income tax return.
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Medicare Levy Exemption Certification Form PDF 61Kb- Less than 1 minute to download on a 56K modem. |
Medicare Two Way Form
Private health fund claim/change of address form.
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Medicare Two Way Form PDF 110Kb- Less than 1 minute to download on a 56K modem. |
Request for Financial Statement Form
You will need a financial statement if your medical expenditure exceeds
the current threshold set by the Australian Taxation Office (ATO) for
tax purposes and you are required to show this expenditure on your tax
return. This is an online service and you will need to login. For more
information see Medicare's frequently asked questions.
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Request for Financial Statement Form |
