Epc form 2026

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The document outlines the Enhanced Primary Care (EPC) Program referral form for individual Allied Health Services under Medicare, which must be completed by a referring General Practitioner (GP). It details eligibility criteria for patients, including the requirement for a GP Management Plan and Team Care Arrangements. The form allows GPs to refer patients to various allied health professionals while noting that Medicare rebates and private health insurance benefits cannot be claimed simultaneously. It specifies the number of services eligible patients can access annually and includes instructions for record-keeping and reporting by allied health professionals.

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Click ‘Get Form’ to open the EPC form in the editor.
Begin by filling in the GP details section. Enter your Provider Number, Name, Address, and Postcode accurately.
Next, complete the Patient details section. Input the Medicare Number, Patient’s reference number, First Name, Surname, Address, and Postcode.
In the Allied Health Professional (AHP) section, specify the name or type of AHP you are referring to. For example, enter 'EBR PHYSIO' along with their address and postcode.
For Referral details, indicate the number of services required for each AHP by writing in the ‘No. of services’ column next to the relevant item number.
Finally, ensure that you sign and date the form at the bottom as a confirming GP.

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Versions	Form popularity	Fillable & printable
2010	4.2 Satisfied (53 Votes)
2009	4.7 Satisfied (59 Votes)
2006	4 Satisfied (28 Votes)
2005	4.4 Satisfied (39 Votes)
2004	4 Satisfied (40 Votes)

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Epc form 2026

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epc referral form pdf

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