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If a person who is 14 years and over is not able to make decisions for themselves, and you have the authority to act on their behalf, you can apply to be their authorised representative.

How to apply 

To apply to become someone's authorised representative, download and complete part B of the 'Application to register for a My Health Record' form and submit with the relevant supporting information.


Supporting information

To support your application, you must provide:

  • Your identity details such as name, date of birth, Medicare number and 100 points of certified Evidence of Identity documentation 
  • The person's (your dependant's) identity details such as name, date of birth and Medicare number
  • Your authority to act on behalf of the person (further details below)
  •  Written advice from a medical practitioner or psychologist to show the person lacks the capacity to make decisions for themselves 

To demonstrate your authority, you can show:

  • Enduring guardianship or guardianship order
  • Enduring power of attorney
  • Statutory declaration outlining your relationship to the person, and declaring that to the best of your knowledge there is no other person with legal authority to act on their behalf (Please note: your application may be stopped or not granted if someone with more responsibility or legal authority exists.)

Submit your application

Send your application form and copies of your supporting evidence to:

My Health Record Program     
GPO Box 9942