Rural Health Professionals Program Claim Form

Claim Details

To submit a claim for RHPP support please:
1. Complete the form
2. Attach eligible tax invoices/receipts for eligible items in accordance with the Approved Plan
3. Submit claim and attachments to RDWA for processing

1. Name: *This question is required.

2. Email: *This question is required. This question requires a valid email address.

3. Claim: *This question is required. This question requires a valid currency format.

	Accommodation assistance for the first 3 months of employment
	Relocation costs
	Visa and migration costs
	Continuing Professional Development (CPD) costs
	CPD relief costs such as locums
	Accreditation and registration processes
	Fuel costs for outreach services
Total : 0

4. Proof of payment:
Attach eligible tax invoices/receipts here, multiple files can be uploaded.Please remember to click Upload after selecting each file.

File: {{filename}} delete

5. Please provide any additional information to support your claim

6. Certification: *This question is required.

I certify that the information contained in this form is correct

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