Claim for a Commonwealth Seniors Health Card form (SA296)
Use this form to claim a Commonwealth Seniors Health Card if you are age pension age.
Download and complete the Claim for a Commonwealth Seniors Health Card 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: 18 December 2020
This information was printed 10 September 2021 from https://www.servicesaustralia.gov.au/individuals/forms/sa296. It may not include all of the relevant information on this topic. Please consider any relevant site notices at https://www.servicesaustralia.gov.au/individuals/site-notices when using this material.