MyMedicare

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MyMedicare Information

Registration Form

If you hold a valid Medicare or Department of Veterans’ Affairs Veteran card and have been to see us in person twice over the last 24 months, you’re now eligible to register in MyMedicare.

MyMedicare is a voluntary patient registration model. It aims to formalise the relationship between patients, their general practice, general practitioner (GP), and primary care teams. MyMedicare patients and their usual GP and practice will have access to new benefits to help deliver more of the care patients need, improving health outcomes.

Your Name*
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MyMedicare Agreement

By signing this form I agree to the following:

  1. I understand that registering in MyMedicare is voluntary.
  2. I consider this Practice to be my regular primary health care provider.
  3. I understand that I can only be registered with one Practice at a time. By submitting this form, any existing registration in MyMedicare will be withdrawn, and my previous Practice and provider will automatically be notified that I am no longer registered with them under MyMedicare.
  4. I understand that I will remain registered unless:
    • I register with a different Practice.
    • I request my GP/Practice or Services Australia to withdraw my registration.
    • My GP or Practice decides to withdraw my registration.
  5. I understand that there is no cost to register in MyMedicare.
  6. I declare I have read and understand the MyMedicare Privacy Notice and consent to my personal information being collected, used and disclosed by the relevant agencies such as Services Australia, the Department of Health and Aged Care, the Australian Digital Health Agency and, where applicable, the Department of Veterans’ Affairs as specified in the MyMedicare Privacy Notice (a link to this notice is provided in the Privacy Statement at the bottom of this form).
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MyMedicare Consent Information

Consent for MyMedicare registration for patients under 14 years of age must be provided by the patient’s parent or legal guardian.

Patients aged 14-17 years must provide their consent to register for MyMedicare.

  • A parent or guardian of a patient aged 14-17 years may complete the Registration Form if the 14-17 year old is aware of the registration and has provided their consent for this person to act on their behalf.

For a patient 14 years or older, who lacks capacity to make decisions for themselves, consent for the MyMedicare registration will need to be provided by an individual who is authorised to act on the patient’s behalf.

Providing this information is voluntary

Are you of Aboriginal or Torres Strait Islander descent?
In which country were you born?

What is the main language you speak at home?

How well do you speak English?
How do you describe your gender?
Gender refers to current gender, which may be different to sex recorded at birth and may be different to what isindicated on legal documents. Please select one box:
How do you describe your sexual orientation? Only complete this question if you are aged 15 years or over.
In everyday life, do you have difficulty participating in any of the following, related to a long-term health condition or disability?
Activities of independent living, such as: shopping, cooking, caring for others, making decisions, handling stress, learning, solving problems, relationships with people
In everyday life, do you have difficulty participating in any of the following, related to a long-term health condition or disability?
Daily activities such as: washing, dressing, walking, handling or lifting objects speaking, using communication devices
In everyday life, do you have difficulty participating in any of the following, related to a long-term health condition or disability?
Activities of work, education and community living, such as: social and community life, work, education or training
The categories below are disability groups based on underlying health conditions and or impairments,activity limitations and participation restrictions. Whichof the following best describes your health condition ordisability? (Please tick the box next to any that apply – you can select more than one box)
Privacy Statement

Privacy Statement

The law regulates how Services Australia, the Department of Health and Aged Care, the Australian Digital Health Agency, and the Department of Veterans’ Affairs may handle your personal information. Services Australia is collecting your personal information to assess your eligibility for MyMedicare and provide services to you and payments linked to your provider as a result of your MyMedicare registration. Your information will only be shared with relevant government agencies such as the Department of Health and Aged Care, Australian Digital Health Agency, and the Department of Veterans’ Affairs, where you have agreed, or where the law allows or requires it.

The MyMedicare Privacy Notice describes how your information will be managed consistent with our obligations under the Privacy Act 1988 and the Australian Privacy Principles. The notice can be found at https://www.health.gov.au/resources/publications/mymedicare-privacy-notice.

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