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Their own affairs because of a medical condition. For more information about Medicare or for assistance completing this form, go to humanservices.gov.au/medicare or call 132 011 24 hours a day, 7 days a week. www. Purpose of this form Note: Call charges may apply. Use this form if you want to act on behalf of someone who is incapable of managing their own affairs for Medicare services. Filling in this form The person applying to be the authorised representative must complete this form.
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