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Printable form

Set up a record via a printable application form

Download and complete the form to set up a record.

Register for My Health Record

  1. Download the Register for My Health Record form (PDF, 448.9 KB) 
  2. You will need to supply identity documents to accompany your application form. You will need to provide 100 points of identification when you submit the form. Copies of your identity documents must be certified. The form provides details about what documents you can provide and who can certify them. If any of your identity documents are not in English, you need to provide certified copies of both the original document and the English translation. Copies of foreign language documents without an English translation cannot be processed.
  3. Send your application form and certified copies of identity documents to:

    My Health Record
    GPO Box 9942
    Sydney NSW 2000

Need assistance with your form?

If you need help with the form, call the Helpline on 1800 723 471 (select option1).

When your application has been processed, you will receive a letter with your Identity Verification Code. You need this code to view your record.

Register with a pseudonym

If you’re concerned about using your real name, you can use a different name to register. The first step to registering for My Health Record with a pseudonym is to apply for a Pseudonym Individual Healthcare identifier.

If you do not have a pseudonym, you can apply for one through Services Australia or call 1300 361 457.

Your Pseudonym Individual Healthcare identifier isn’t linked to your Medicare information and you will not be eligible to claim services under the Pharmaceutical Benefits Scheme (PBS) and the Medicare Benefits Schedule (MBS).

Once you have a pseudonym, download and complete the Register with a pseudonym form (PDF, 649.47 KB)

Send your application form and supporting evidence to:

My Health Record
GPO Box 9942
SYDNEY NSW 2000

Register a dependant

You can be appointed as an authorised representative based on your relationship to the person you are representing, their age, whether they have a record, and whether they have the capacity to manage it.

Download and complete the Register a dependant form (PDF, 528.05 KB) 

Send your application form and supporting evidence to:

My Health Record
GPO Box 9942
SYDNEY NSW 2000

I’ve applied for a My Health Record and want to find out the progress of my application

We are currently receiving a high volume of applications and it is taking longer than usual to process them.

Once a My Health Record application form has been processed you will be sent a letter to the address you have registered with Medicare (or the Healthcare Identifiers Service) advising your registration has been successful. The letter will contain an Identity Verification Code which you need to access your record online.

Find out more if need proof of your vaccinations.

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