General Practices

Following are specific forms relating to the Indigenous Health Access Scheme (IHAS), Manngoor Dja Chronic Disease Management Program (CDMP),  and Closing the Gap (CTG). 

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Indigenous Health Access Scheme (IHAS)

• CDMP GP Referral Form (word version)
• CDMP GP Referral Form (PDF)

Closing the Gap (CTG)

• (Practice Only) Practice Incentives Application Form
• (Practice Only) Practice Incentives – Adding a new General Practitioner or Nurse Practitioner Form
• Patient Registration Form – PBS Co-Payment & PIP-IHI (CTG)
• Multiple Patient Registration Form – PBS Co-Payment & PIP-IHI (CTG)
• “715” Fact Sheet – Health Assessment for Aboriginal and Torres Strait Islander People
• “715” Health Assessment Templates – (Full age spectrum for Aboriginal and/or Torres Strait Islander People)

       – Child (0-14) Health Assessment

       – Child (0-14) Health Assessment (rich text format. rtf)

       – Adult (15-54) Health Assessment

       – Adult (15-54) Health Assessment (rich text format. rtf)

       – Older Person (55+) Health Assessment

       – Older Person (55+) Health Assessment (rich text format. rtf)

• “715” Referral form for follow-up allied health services for Aboriginal and/or Torres Strait Islander people (81300-81360)
• “715” Recall letter for Practices (rich text format. rtf)
• MBS ITEMS 81300-81360 Fact Sheet
• MBS ITEM 10987 Fact Sheet
• Care Plan Referral form for follow-up allied health services for patients with a chronic condition (10950-10970)