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Provider registration form

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Essentials for TAC providers
What we can pay for
How to seek TAC approval
How to invoice the TAC
Clinical Framework
Outcome measures
Register with the TAC Start Register with the TAC Navigation [2nd Level]
- Health and service providers registration
- Disability service providers
End Register with the TAC Navigation [2nd Level]

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Attention disability services providers

Additional requirements apply for providers who deliver these services to TAC clients: attendant care, Client Independence Skills Services (CISS), Shared Supported Accommodation (SDA) and outreach services. Please refer to the disability services registration information.

Provider details

First Name *

Last Name *

Provider type

Company Name if payable to the company

ABN

Telephone number *

Fax number

Service Location

Address

Suburb/City

State

Postcode

Postal Address

Tick if same as service location address

Address

Suburb/City

State

Postcode

Email Address *

I do not want to receive email news from the TAC

Bank Account details

Name of bank or financial institution

BSB number (no spaces)

Account number (no spaces)

Name/s of account holder

Name of Account