Mass 84 2026

The document outlines the Proxy Access to Centrelink Information Form for the Medical Aids Subsidy Scheme (MASS) in Queensland. It allows applicants aged 16 and over to consent for MASS staff to access their Centrelink concession card information when a photocopy is not provided. The form emphasizes confidentiality, the purpose of accessing eligibility for assistance, and the process for revoking consent. It includes sections for applicant details and instructions for submitting the form to various MASS service centers.

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Click ‘Get Form’ to open it in the editor.
Begin by providing your personal information in the 'Applicant Confirmation' section. Enter your name and ensure that you authorize Centrelink to confirm your current benefit status.
In the 'Concession Card Provider' section, select either Centrelink or Department of Veteran’s Affairs by ticking the appropriate box.
Fill in the details of your concession card, including the type, number, name of the cardholder, address on the card, issue date, and expiry date if applicable.
Sign and date the form at the bottom to confirm your consent for MASS to access your Centrelink information.
Once completed, save your document and choose to post or fax it to one of the MASS Service Centres listed at the end of the form.

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Versions	Form popularity	Fillable & printable
2021	4.9 Satisfied (58 Votes)
2018	4.1 Satisfied (28 Votes)
2015	3.9 Satisfied (51 Votes)

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