Application for a Medicare provider number and, or prescriber number for allied health and non-medical health professionals form (HW093)

Use this form if you are applying for an initial or subsequent Medicare provider number or a PBS prescriber number or both.

Download and complete the Application for a Medicare provider number and, or prescriber number for allied health and non-medical health professionals form.

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: 17 November 2022