Centrelink proxy form 2026

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The document outlines the Proxy Access to Centrelink Information Form for the Medical Aids Subsidy Scheme (MASS) in Queensland. It allows applicants to consent for MASS staff to access their Centrelink concession card information when a photocopy is not provided. The form emphasizes confidentiality and details the necessary information required from the applicant, including personal and concession card details. It also explains the implications of providing or withdrawing consent regarding eligibility for assistance and services from MASS.

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Click ‘Get Form’ to open the Centrelink Proxy Access to Information Form in the editor.
Begin by selecting the Concession Card Provider. You can choose between Centrelink or the Department of Veteran’s Affairs by ticking the appropriate box.
Fill in the Type of Concession Card, such as Health Care Card, and provide the Applicant’s Concession Card Number.
Enter the Name of Card Holder and Address on Card accurately to ensure proper identification.
Input the Issue Date and Expiry Date on Card if applicable. This information is crucial for verifying your eligibility.
In the Applicant Confirmation section, write your name and authorize MASS to access your Centrelink information by signing and dating the form.
Once completed, you can easily email, post, or fax your form to a MASS Service Centre using our platform's sharing features.

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