NHI Lookup Service Application Form
This application form should
not be used for new
HealthLink EDI accounts. Please use
here if you need an EDI account.
Please complete the application form
below. (Required fields marked with *)
Service Agreement *
NOTE: After submission of your application, a comprehensive NHI application pack will be posted to the person you indicate on the application form above. This application needs to be completed in full and posted back to HealthLink. Please note that the process of approval may take 6 weeks or longer. You will be notified by HealthLink once the NHI Access has been implemented for your practice.
I hereby apply on behalf of the afore mentioned practice / organisation to use the services offered by HealthLink Ltd and agree to comply with all terms and conditions
set out in the Healthlink Service
Agreement including all schedules published at www.healthlink.net.
view the Service Agreement? Click here
to download the Adobe Reader