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Financial assistance policies and forms

Download a PDF Application to print out and complete - or use our online forms by following the link.

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Online Application Forms

Application for Dental Assistance

Please include your BSB, Account Number, Account Name & Bank Name

I, the above named, confirm that I have paid the above dentist’s bill and am seeking reimbursement of up to $1500 to the bank account above.

Date
Day
Month
Year
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We acknowledge the traditional custodians of the lands on which we live, work, and play. We recognise the cultural, spiritual, physical, emotional, intellectual and economic connection to their lands, water, flora, and fauna.We honour and pay respects to all elders; past, present, and emerging, as well as all generations of people now and into the future, for they hold the memories and the future.

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