Please switch to a modern browser as the web browser you are currently using is not supported
due to being insecure and out of date.
Alternatively you can download a copy of the offline form from the link in the header.
Alternatively you may choose to upload an Excel spreadsheet that lists your providers.
This can be done instead of manually inputting the providers details.
I understand and accept this agreement with the knowledge that Medical-Objects Pty Ltd will be using the personal information provided by me on this form in order to supply Medical-Objects Health Software Products and Services and not for unsolicited communication or marketing. I understand and accept that Medical-Objects products, services and personal information will be used by us for managing healthcare information, services and communications only. I understand that it is our responsibility to provide adequate security to protect personal and sensitive information located on our premises.
I understand that software support covers Medical-Objects products and services only. I agree to the Medical-Objects terms and conditions found at www.medicalobjects.com/MedicalObjectsSLA.pdf. I understand the Medical-Objects Refund Policy found at www.medicalobjects.com/refund-policy. I agree to notify Medical-Objects Pty Ltd of any problems or errors and to provide feedback directly.
There was an error while trying to finalise the form, please try again.
If this continues to happen, please print the form as a backup and contact Medical-Objects.
To submit your form to Medical-Objects you have two options:
Note: It is strongly recommended that you save a copy of the form for safe keeping.
A confirmation e-mail has been sent to
Please check your e-mail and follow the instructions.
If you do not receive the e-mail please check your spam or junk folder. If you still did not receive it please
contact us and quote
your application ID: .
Medical-Objects uses Medicare Provider Numbers as the delivery address for messages so it's vital that you provide one.
If the provider you are adding does not have one please continue and let us know in the Additional Notes
section later in the form.
Are you sure you wish to continue adding without a Provider Number?