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 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.

To fill in this form digitally you will need a computer and Adobe Acrobat Reader, or a similar program. You can download Adobe Acrobat Reader for free. If you can’t complete the form digitally, you can print it, complete it by hand and return it to us following the instructions on the form.

If you have a disability or impairment and use assistive technology, you may not be able to access our forms. If you can’t, please contact us. We can help you access, complete and submit them.

Page last updated: 1 October 2024.
QC 20561