In a life threatening emergency dial Triple Zero (000)

In a life threatening emergency dial Triple Zero (000)
ACT Public Hospitals

Canberra Hospital

5124 0000


Calvary Hospital

6201 6111

Mental Health

Call Mental Health Triage on

1800 629 354

(free call except from mobiles or public phones) or

6205 1065

Poisons Hotline

For a poison emergency in Australia call

131126

Drug and Alcohol Help Line

The Drug and Alcohol Help Line is available 24-hours, 7 days a week on

5124 9977

Health Protection Service

For after hours urgent public health matters including environmental health, radiation safety, food poisoning and communicable disease management phone:

(02) 6205 1700

healthdirect

24 hour health advice

1800 022 222

ACT State Emergency Service

Emergency help
during flood or storms

132 500

Forms


Cardholder HandbookCardholder Handbook


Cardholder Handbook [PDF 96KB] [Word 180KB]




Cardholder BrochureCardholder Brochure


Cardholder Brochure [HTML] [PDF 28KB]



Application formCardholder Application form


Cardholder Application Form [PDF 262LKB] [Word 324KB]




Affiliate BrochureBusiness Affiliate Brochure


Business Affiliate Brochure [PDF 409KB] [Word 443KB]




Affiliate formBusiness Affiliation Form


Business Affiliation Form [PDF 219KB]




Affiliate Terms and Conditions

Affiliate Terms and Conditions [PDF 178KB] [Word 189KB]


Cardholder Terms and Conditions

Cardholder Terms and Conditions [PDF 186KB] [Word 123KB]


About PDF Forms

There are two main PDF versions of the forms provided on this web site - interactive and non-interactive versions. The interactive version contains fields that allow data input. This means you can 'fill out' a PDF form with the required information.

The interactive PDF forms only allow you to type your details onto the form. To file your documents you will still need to print them and file them in the traditional manner using the paper version.

You will need Acrobat Reader or Adobe Acrobat installed on your computer for interactive forms to work. You can get a free copy of Acrobat Reader from the Adobe website.

Accessibility

The ACT Government is committed to making its information, services, events and venues, accessible to as many people as possible.
If you have difficulty reading a standard printed document and would like to receive this publication in an alternative format – such as large print or audio – please telephone (02) 6205 0282.

If English is not your first language and you require the translating and interpreting services – please telephone 131 450.
If you are a TTY typewriter service user – please telephone 133 677 then ask for 133 427.