Private Health Insurance Statements (Tax Statement) for members will be available in your St Lukes connect account and your MyGov account from mid-July. Learn more.

Forms and brochures

Forms and brochures

Download resources for forms, brochures, government information and general information here.

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St Lukes Health Management Program Form

Form

Download
Transfer Certificate Request

Form

Download
Benefit Refund Form

Form

Download
Student Dependant Declaration Form

Form

Download
Medical Certificate for Pre Existing Condition Form

Form

Download
Claims History Release Form

Form

Download
Credit Card Authorisation & Direct Debit Service Agreement form

Form

Download
Authority to Operate a Membership Form

Form

Download
St Lukes Direct Debit Request & Service Agreement

Form

Download
Agent Authority Claiming Form

Form

Download
Overseas Suspension of Policy Form

Form

Download
Provider Registration Form

Form

Download
The Australian Government Rebate on PHI Form

Form

Download
Authority to Deduct From Salary Form

Form

Download
St Lukes Privacy Complaint Form

Form

Download