Register New User | medcertificates.com.au

{'IdentificationType': 'Australian Drivers Licence or Lerner Permit'}

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Account Details:

* Username:

* Password

* Repeat Password

Please take care as the following name will appear on your certificate and must match your identification:

Title (Optional)

* First Name

* Last Name

* Medicare Card Details

I do not have a medicare card

* Date of Birth

* Day

* Month

* Year

What was your assigned gender at birth (optional)

Do you identify as an Aboriginal or Torres Strait Islander (optional)

Occupation (optional)

* A‌ddress:

Street1:

Street2:

City:

State:

Postcode:

Country:

(Optional) Phone:

* Mobile

* Verification Code

* Email Address

Relevant Medical History: (optional)

If you have any past medical problems (e.g. asthma, diabetes) please list these below: (optional)

If you take any medications regularly please list these below: (optional)

If you any medication allergies please list these below: (optional)

Identification:

As a medical certificate is a legal document, it is important that you are properly identified.

Please provide a picture of your driver's licence, passport, photo identification card (AusPost) or proof of age card.

* Identification Type

* Identification Document

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