Bali 2005 registration form (MS023)

Use this form to register for Bali 2005 health care costs assistance scheme benefits.

Download and complete the Bali 2005 registration form.

This PDF is fillable. You can fill it out on your device, or print it and complete it by hand.

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 use self service, request someone to deal with us on your behalf, or contact us. We can help you access, complete and submit them.

Page last updated: 29 June 2021