Authorisation to act on an incapacitated person s behalf for medicare purposes (mo050) 2025

1. Click ‘Get Form’ to open it in the editor.
2. Begin by entering the Medicare customer’s details. Fill in their Medicare card number, name, gender, date of birth, and addresses. Ensure all information is accurate and complete.
3. Provide proof of your identification. Upload a document such as an Australian Driver's license or Passport. This step is crucial for verifying your identity.
4. Complete the statutory declaration section, stating your relationship to the customer and your responsibilities. This declaration affirms your role as their representative.
5. Attach evidence of a similar arrangement if applicable, such as documentation from Centrelink or NDIS that confirms your authority to act on their behalf.
6. Include evidence of the customer’s medical condition by uploading relevant documents dated within the last month, ensuring they include necessary professional details.
7. Review all entered information for accuracy before submitting. Once satisfied, return the form via email or post as instructed at the end of the document.

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