Get User Guidepatient Registration (form A)

This guide provides clear and supportive instructions for filling out the User GuidePatient Registration (Form A) online. By following these steps, users can efficiently complete the registration process, ensuring all necessary information is accurately submitted.

Follow the steps to complete the registration form online.

1. Press the ‘Get Form’ button to access the registration form and open it in your preferred editor.
2. Begin with Section A, which requires patient or guardian/carer details. Fill out your title, given names, family name, preferred name, and date of birth in the format DD/MM/YYYY. Ensure residential address, suburb/town, and postcode are accurately provided.
3. If your postal address differs from your residential address, input that information, including the suburb/town and postcode.
4. Provide a mobile number or landline (if a mobile is not available), along with your email address for further communication.
5. Indicate whether you identify as Aboriginal and/or Torres Strait Islander by selecting the appropriate option.
6. If there is a preferred contact person different from the patient, enter their mobile number, relationship to the patient, and email address.
7. Choose how you would like to be contacted by selecting one or more communication methods: text message, email, phone, or mail.
8. Proceed to Section B, where you must input your Medicare card number and its expiry date (MM/YY).
9. Check any applicable boxes for Department of Veterans Affairs, Healthcare card, Pensioner concession card, or Commonwealth Seniors card. Fill in corresponding card numbers and expiry dates.
10. In Section C, read the consent statement carefully. Provide your signature (if you are 18 years or older) or the signature of a guardian/carer (if under 18). Fill in the date of signing in the format DD/MM/YYYY and include the guardian/carer’s name and contact number.
11. Review all entered information for accuracy before submission. Save your changes, and choose to download, print, or share the completed form as needed.

Complete your User GuidePatient Registration (Form A) online now for a seamless registration experience.