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Form 1392 – Pregnancy Health Undertaking (Fillable PDF)

  1. Language English
  2. Country Australia
  3. Activity Health
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Form 1392 – Pregnancy Health Undertaking (Fillable PDF)

Form 1392 is the official Pregnancy Health Undertaking required by the Australian Department of Home Affairs for certain visa applicants. The form confirms that you will undergo a chest X‑ray after childbirth, satisfying the health requirement for a protection visa.

What is Form 1392?

This government‑issued PDF explains the obligations of both the applicant and the Australian Government regarding health examinations during pregnancy. It is part of the broader health undertaking process for visas that involve significant health conditions.

Why Use a Fillable PDF Version?

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Step‑by‑Step Guide to Complete Form 1392

Follow the simple steps below to complete the form using Formize’s online PDF filler.

Common Mistakes to Avoid

Before you submit, double‑check that you have:

  • Entered your full legal name exactly as it appears on your passport.
  • Provided a current Australian address where the health provider can contact you.
  • Signed the form electronically or printed and signed if required.
  • Attached any supporting medical documents referenced in the undertaking.

Where to Get Help

If you have questions about the health undertaking, contact your Migration Medical Services Provider (Bupa Medical Visa Services) or consult the official health undertaking guide.

FAQ
  • What is the purpose of Form 1392?

    Form 1392 is a pregnancy health undertaking that obligates visa applicants to have a chest X‑ray after birth, ensuring they meet Australia’s health requirements.

  • Can I fill Form 1392 on a mobile device?

    Yes. The Formize PDF Filler works on smartphones and tablets, allowing you to complete the form anywhere with an internet connection.

  • Do I need to print and sign the form?

    Electronic signatures are accepted in most cases. If your visa officer requests a handwritten signature, you can print, sign, and scan the final PDF.

  • How long does the health undertaking remain valid?

    The undertaking is valid for 12 months from the date you sign it. You must complete the post‑birth X‑ray within 28 days of receiving the Request for Information letter.

  • What should I do if I make a mistake after submitting?

    Contact your Migration Medical Services Provider (Bupa) immediately. They can advise whether a corrected form needs to be resubmitted.

  • Is there a fee to use Formize’s fillable PDF service?

    Formize offers free online filling for this government form. No hidden charges apply.

HOW TO

How to fill out form 1392 for free, online in 5 easy steps:

  1. 1
    Click the Fill button
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  2. 2
    Wait for the filler to load
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  3. 3
    Enter your information
    Type directly into each highlighted field—name, passport number, address, and medical details.
  4. 4
    Review and sign
    Check every entry for accuracy, then use the electronic signature tool or print to sign manually.
  5. 5
    Save or submit
    Download the completed PDF, store it securely, or follow your visa officer’s instructions to submit.
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ABOUT

Medicare Application Forms

form 1392 is one of Medicare forms that are documents used in the administration of the Medicare program, which is a federal health insurance program in the United States primarily for individuals aged 65 and older, as well as certain younger individuals with disabilities or specific medical conditions. These forms are used for various purposes related to enrolling in, managing, and accessing Medicare benefits. Here are some common Medicare forms:

Medicare Application Forms: These forms, such as the CMS-40B, are used to apply for Medicare benefits, including Part A (hospital insurance) and/or Part B (medical insurance). They require personal information, such as name, address, Social Security number, and information about current health insurance coverage.

Medicare Enrollment Forms: These forms, such as the CMS-855B for healthcare providers, are used by healthcare professionals, suppliers, and organizations to enroll in the Medicare program. They gather information about the provider or organization and their qualifications to participate in Medicare.

Medicare Claim Forms: These forms, such as the CMS-1500 or UB-04, are used to submit claims for reimbursement of medical services rendered to Medicare beneficiaries. Healthcare providers or suppliers complete these forms to seek payment for covered services.

Medicare Prescription Drug Plan Forms: These forms, such as the CMS-10260, are used to enroll in Medicare Part D prescription drug plans or to make changes to existing plans. They require information about the medications a beneficiary takes and their preferred pharmacy.

Medicare Authorization Forms: These forms, such as the CMS-10114, are used to authorize the release of personal health information from Medicare records to designated individuals or organizations. This allows beneficiaries to grant access to their medical records for specific purposes.

Medicare Appeal Forms: These forms, such as the CMS-20027, are used to request an appeal if a claim is denied or if there is a disagreement with a Medicare decision. They provide a process for beneficiaries or their representatives to seek a review of coverage determinations or payment decisions.

These are just a few examples of the various Medicare forms that exist. The specific forms and requirements may vary, so it's important to consult the official Medicare website or contact the Medicare administrative authority for accurate and up-to-date information.

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