Completing this form
When completing the form, please provide as much information as possible about the allegation, including where and when it occurred. It should only take a few minutes of your time to complete.
This form allows you to provide information about a health provider, an organisation, or their employees.
Before you start
If you see a name that you do not recognise on your Medicare statement, consider whether you may have had a service from someone other than your usual provider, such as:
- an eye test
- a pathology test
- a PCR test
- diagnostic imaging.
There are some issues that we cannot help you with. You can report these things to other authorities:
- Reports about vaccine certificates – submit these to Services Australia (Proof of COVID-19 vaccinations for businesses - Running a business - Services Australia)
- Reports about patient safety or harm - submit these to the Australian Health Practitioner Regulation Agency (AHPRA)
- Rude, racist, inappropriate professional conduct, not listening, dismissive, service quality or interaction issues (also AHPRA)
- Suspected Medicare, pharmaceutical or Centrelink fraud by a member of the public (not a health provider or their employee) – submit these to Services Australia
- Suspected fraud against activities funded by the Department of Health and Aged Care (such as services, grants or other payments); or fraud or corruption by departmental staff – refer to Report suspected fraud - Department of Health and Aged Care.
Should you require more information about what can be reported on this form please refer to Health provider related tip-offs page
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