Online claiming provider agreement form (HW027)
Use this form to register for online claiming with us and the Department of Veterans' Affairs.
Download and complete the Online claiming provider agreement 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 contact us. We can help you access, complete and submit them.
Page last updated: 9 March 2021
This information was printed 16 April 2021 from https://www.servicesaustralia.gov.au/organisations/health-professionals/forms/hw027. 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.