Request for pay group link form (HW078)

Use this form to request a pay group link so you can have Medicare benefit cheques made payable to another payee associated with the practice or another address.

Download and complete the Request for pay group link form.

Medicare benefit cheques are usually made payable to the provider at their location address.

This PDF is fillable. Download this form and complete it on your device, or print it and complete it by hand.

If you have a disability or impairment and use assistive technology, there are other ways you can do your business with us. You can use self service or request someone to deal with us on your behalf. If you can’t access our forms, please contact us. We can help you access, complete and submit them.

Page last updated: 4 February 2020