HI Service - application to amend details of a contracted service provider organisation record form (HW043)

Use this form to add or amend the record of a Contracted Service Provider (CSP) organisation within the Healthcare Identifiers (HI) Service.

You must download our forms and fill them in so they are processed quickly. You can also electronically sign some of our forms. We have help available if you use assistive technology.

Download and complete the HI Service - application to amend details of a contracted service provider organisation record form.

You must ensure that the amendments made to a CSP organisation details do not deem the CSP organisation ineligible for ongoing use of a CSP registration number under the Healthcare Identifiers Act 2010.

Page last updated: 17 November 2022.
QC 21051