Application for an authorised recipient to apply for or renew access to the Provider Directory System form (MO003)

Use this form to seek authorisation for a contact person to access data and receive correspondence in the Provider Directory System.

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 Application for an authorised recipient to apply for or renew access to the Provider Directory System.

You’ll need an individual Provider Digital Access (PRODA) account when applying to be approved as an Authorised Recipient.

This form must be signed by the Chief Executive Officer or the Public Officer of an incorporated body, for example, Health Sector Entity Representative.

Page last updated: 6 December 2024.
QC 21141