By completing this Agreement, you are authorised to receive the General Practice Immunisation Incentives practice report (GPII020A) from the Australian Childhood Immunisation Register (ACIR). This agreement is made by either ‘an individual immunisation provider’ or ‘a medical practice’ and outlines your obligations under section 46E of the Health Insurance Act 1973 regarding the use and storage of the information contained in the report. The GPII020A report is available to practices the children included incentives Program (PIP) and identifies the children included in your practice’s GPII outcomes payment calculation. The order form is on the CSGPN web site to find under immunisation.

If you have any question about the form and support with data cleaning please call Marlen 8752 4918.

Reference: www.medicareaustralia.com.au