2025 Printable Template
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Form last updated: 03/2024. Please verify this is the current version before use.
Easily complete & submit your MS003 form
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Sign the form
Add your electronic signature to the fillable MS003 form to certify it came directly from you.
Send it to the requester
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What is a MS003 used for?
Form MS003 is used to request a unique 16-digit Individual Healthcare Identifier (IHI), which helps in managing health records. This identifier facilitates communication among healthcare providers and supports the creation of a My Health Record for individuals not eligible for Medicare or DVA benefits.
Who needs to fill out a MS003 form
Individuals not eligible for Medicare or DVA benefits who need an Individual Healthcare Identifier.
How to fill out a MS003 online?
Follow these steps to complete your MS003 form online.
Frequently Asked Questions
Find quick answers to common questions about our PDF editor.
It is a form to request an Individual Healthcare Identifier for better management of health records.
Individuals not eligible for Medicare or DVA benefits who require an IHI.
It is not needed for those already eligible for Medicare or receiving DVA benefits.
Submit the completed form through myGov, email, fax, or postal service.
