Request for pay group link form (HW078)

Use this form to request a pay group link so you can have Medicare benefit cheques made payable to another payee associated with the practice or another address.

Download and complete the Request for pay group link form.

Medicare benefit cheques are usually made payable to the provider at their location address.

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: 3 March 2022