HI Service - application to amend a healthcare provider record form (HW034)

Use this form to amend a Healthcare Provider Identifier Individual (HPI-I) record with the Healthcare Identifiers (HI) Service.

Download and complete the HI Service - application to amend a healthcare provider record form.

Use the Healthcare provider type to help you fill out this form.

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

You can upload or complete this form online through HPOS. Read more about form upload in HPOS.

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: 18 September 2020