Forms

Australian Government Rebate Form July 2023 (Print PDF) 
Download, complete and return the Australian Government Rebate Form to Latrobe Health Services.

Latrobe Accident Form (Print PDF) 
Download, complete and return the Accident Form to Latrobe Health Services.

Latrobe Clearance Certificate Request Form
Download, complete and return the Clearance Certificate Request Form to Latrobe Health Services.

Latrobe Direct Debit Authority Form
Download, complete and return the Direct Debit Authority Form to Latrobe Health Services.

Latrobe Membership Application Form
Download and complete the Membership Application Form to join Latrobe, change your membership or alter your level of cover.
Waiting periods, default and limited benefits, restricted benefits, limits, co-payment and excesses may apply. Please refer to the terms and conditions of waiting periods.

JobKeeper JobSeeker Deferral Application Form
Download, complete and return the Job Keeper Job Seeker Deferral Application Form to Latrobe Health Services

Hardship Application Form
Download, complete and return the Hardship Application Form to Latrobe Health Services

Claiming

Once you have already submitted your medical claims to Medicare you’ll only need to complete  a Latrobe Claim Form and forward this with your Medicare Statement of Benefits.

Latrobe Third Party Authority Form (Print and Interactive PDF) 
This authority will allow nominated persons to make claims, enquiries and alterations to your membership on your behalf.

Latrobe Orthodontic Form (Print PDF) 
Download, complete and return the Orthodontic Form to Latrobe Health Services.

Latrobe Orthodontic Form (Interactive PDF) 
Download, complete and return the Orthodontic Form to Latrobe Health Services.

Smart 'n Easy Application Form
Have your claim benefits deposited straight into your account.


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Too much paperwork?

Log in to your online member account or register to use this service and make your own changes online. Alternatively, contact us for assistance.