Aged Care Provider Portal - register, amend or remove users form (AC004)

Use this form to register, amend or remove users for the Aged Care Provider Portal if your organisation doesn’t have an Organisation Administrator.

You must download our forms to fill them in. We have help available if you use assistive technology or if you need a translator or interpreter. Find out how to use our forms.

You do not need to use this form if your service has an Organisation Administrator. Organisation Administrators can add and link staff with existing ‘A numbers’ to their service.

Download and complete the Aged Care Provider Portal - register, amend or remove users form.

An authorised person of the approved service must complete and sign this form.

Read more about the Aged Care Provider Portal.

Page last updated: 1 November 2025.
QC 20561