Registration Workshop Checklist

HI Service Registration of Seed HPI-O
No. / Actions Required: / Complete: / Information:
1 / Has your Responsible Officer (RO) completed and signed your Seed HPI-O form?
Form name:
Application to Register a Seed Organisation
Form available at:
http://www.medicareaustralia.gov.au/provider/health-identifier/files/2978-1206-application-to-register-a-seed-organisation.pdf / Check EVERY required tick box has been completed
2 / Has your referee signed and verified each of your documents? / Ensure your referee, Wendy Reid (RN) has written “this is a true copy of the original as supplied to me” on each document and signed and dated it. Ensure the referee has signed to last page of the Seed HPI-O application
3 / Ensure you keep a copy of your form and associated documents / Keep copies of all forms in a special folder
4 / Seed HPI-O application sent / DATE:
PCEHR Registration
No. / Actions Required: / Complete: / Information:
1 / Has your RO or Seed OMO completed and signed your PCEHR Application form?
Form name:
Application to register healthcare provider
organisation in the eHealth record system
Form available at:
http://ehealth.gov.au / Check EVERY required tick box has been completed
Ensure you keep a copy of your form and associated documents
2 / PCEHR application sent / DATE:
PCEHR Participation Agreement
No. / Actions Required: / Complete: / Information:
1 / PCEHR Participation Agreement sent / DATE:
NASH Organisation PKI Certificate Application
No. / Actions Required: / Complete: / Information:
1 / Has your RO filled in a NASH PKI Certificate for Healthcare Provider Organisations application form?
Form name:
Application to Request a National Authentication Service for Health Public Key Infrastructure Certificate for Healthcare Provider Organisations
Form available at:
www.humanservices.gov.au/pki
If you do not have your Seed HPI-O number, this field will be left blank for now. Your Seed HPI-O number will be coming in the post to your preferred address within 4 weeks of you submitting your application. / Until you get your Seed HPI-O number this application should be stored in your Registration Workbook Folder. Once this arrives you can complete the Seed HPI-O field and submit the form.
2 / NASH Organisation PKI Certificate application sent / DATE:
Evaluation/feedback
No. / Actions Required: / Complete: / Information:
1 / Have you completed the Registration Workshop Evaluation Questionnaire, and handed this to your Division facilitators?

Disclaimer: This checklist is provided to assist you to meet your ePIP requirements, including your applications to the Healthcare Identifiers Service and eHealth Record System. It is not an exhaustive list of all the actions your organisation may need to undertake and you should take your own steps to ensure your obligations are met and your practice is prepared to participate in these programs.