Patient Travel Subsidy Scheme (PTSS)

Patient Registration Form A

Section A (patient or guardian / carer to complete)


Section B (patient or guardian / carer to complete)
 * A Medicare card number is required to be eligible for PTSS

Your Personal Information
Personal information collected by Queensland Health is handled in accordance with the Information Privacy Act 2009. Your personal information is being collected in order to assess whether you are eligible to receive a subsidy under the Patient Travel Subsidy Scheme. The personal information provided by you will be securely stored and made available to appropriately authorised officers of Queensland Health. Personal information recorded on this form will not be disclosed to other parties without your consent, unless required by law. For information about how Queensland Health protects your personal information, or to learn about your right to access your own personal information, please see our website at