Delegation of Authority

From time to time, you may require a third party to access your membership details. MIPS is bound by the Privacy Act, and can't provide your membership details to a third party without your written authority.

Complete this form to allow MIPS to provide your membership details to your practice manager, hospital, spouse, employer, or another nominated person.

Please note: The nominated person/s will have authority to obtain your membership details, until MIPS is advised otherwise.  This authority does not apply to any non-membership information, such as claims data.

Delegation of Authority Form (43KB)