Medicare Enrolment Form (MS004) – Fillable PDF

The Medicare Enrolment Form (MS004) is the official document used by Services Australia to register individuals and families for Medicare benefits. This fillable PDF lets you enrol up to five people at once, making it perfect for households, couples, or small families.

What Is the Medicare Enrolment Form (MS004)?

The MS004 form collects personal details, Medicare eligibility information, and any special circumstances such as family or domestic violence considerations. It is required for new applicants, people changing their details, or those adding family members.

How to Complete the Form Online with Formize

Instead of printing, scanning, or using a separate PDF editor, you can fill the form directly on our site. Follow the simple steps below:

Common Mistakes & Tips for a Successful Application

• Double‑check names and dates of birth. A typo can delay processing.
• Provide a valid Australian address. PO boxes are not accepted for enrolment.
• Include all required supporting documents. For example, birth certificates or passports.
• Sign each individual’s section. Electronic signatures are accepted when using Formize.

Where to Submit the Completed Form

Once you have filled and saved the PDF, you can:

• Upload it through your MyGov portal.
• Mail a printed copy to the nearest Medicare office.
• Take the saved file to a local Services Australia service centre.

Related Resources and Help

For further information on Medicare eligibility, the Medicare Safety Net, or assistance for people affected by family and domestic violence, visit the Services Australia Medicare page.