Government Issued ID

Please upload your Government Issued ID

Comments

This field is for validation purposes and should be left unchanged.

In order to provide you with a prescription for medication or any other health service, we need to verify your identity. Since you do not have a Medicare card, we kindly ask that you provide us with your personal information and upload your ID. If you have any questions about the verification process, please feel free to contact us at 1300 858 909.

Name(Required)

First Last

The name of the person requesting the health service.

Date of Birth(Required)

The date of birth of the person requesting the health service.

Email(Required)

Use the same email you used when requesting the health service.

Upload Image of Government Issued ID (eg. Drivers Licence, Passport, Proof of Age Card or Birth Certificate. Needs to clearly show your full name and date of birth.(Required)

Drop files here or

Accepted file types: jpg, gif, png, jpeg, bmp, Max. file size: 15 MB, Max. files: 3.

Upload a copy of your government-issued ID such as an Australian Drivers license, Passport, Proof of Age Card, or Birth Certificate. We need to clearly sight the name and date of birth of the person requesting the health service.

CAPTCHA