Please complete the online form below if you wish to notify us of any change in your contact details.

All fields marked required are mandatory

The information collected in this form will be used to contact you and update your personal details.

Phone

This field is for validation purposes and should be left unchanged.

First Name(Required)

Last Name(Required)

Date of Birth(Required)

UR/Hospital Number

(6 or 8 digit number located underneath your name and address on your letter)

Have your contact details changed?(Required)

Yes

Has your GP changed?(Required)

Yes

Address(Required)

Street Address City / Town State Postcode Country

Daytime phone number

Mobile phone number

Confirm email

Medicare Card Number(Required)

Medicare Care Valid to (expiry date)(Required)

Name of your GP

Name of GP medical practice

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Page last updated: June 30, 2025