Completing this form
When completing the form, please remember it doesn't matter how much or how little information you have, every detail is valuable. It should only take a few minutes of your time to complete.
This form allows you to provide information about a health provider, an organisation, or their employees. Should you require more information about what can be reported on this form please refer to
Health provider related tip-offs page Let's start
*What do you want to tell us?
*Who is this tip-off about?
*Where and when did it happen?
What is the identification/reference number (if known)?
Your details (
you can remain anonymous; however, providing your details will enable us to contact you if more information is needed. If you do provide us with your contact details, we will not reveal your identity in the course of our enquines - See our privacy notice below.) Documents to support your tip-off?
If you have electronic documents you would like to attach to support your tip-off, please upload up to 5 related files here:
If you have hardcopy documents, contact us by email at
firstname.lastname@example.org for advice on how you can get them to us.
*By submitting this form, you declare you understand that deliberately giving false or misleading information is a serious offence.
Your personal information is protected by law, including the
Privacy Act 1988, and is being collected by the Australian Government Department of Health for the purposes of investigating, assessing and responding to fraud or suspicious activity by health providers against the Australian Government's health related programmes.
our privacy notice page.