PIP Indigenous Health Incentive - patient registration and consent form (IP017)

Use this form to register an eligible Indigenous patient in the PIP Indigenous Health Incentive or the Pharmaceutical Benefits Scheme (PBS) Co-payment Measure.

Download and complete either the Word or the PDF version of the:

A practice or Indigenous health service participating in the Practice Incentives Program (PIP) Indigenous Health Incentive should complete this form.

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