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• Confirm the patient/s is being assessed for a fertility issue, which is defined as:
  • because a woman, following regular unprotected sex, (i) who is under 35 years of age has not conceived in 12 months or longer, or (ii) who is 35 years of age or over has not conceived in 6 months or longer (the Female Applicant); and the Female Applicant, (ii) her partner and/or (iii) gamete donor requires assessment for infertility.
• Confirm the patient/s has received one or more of the following fertility test/s:
• AMH
• Pelvic ultrasound
• Ovulation test
• Semen analysis
• These fertility tests could have been ordered by you or another medical practitioner.
• Confirm the patient/s has incurred an out-of-pocket expense associated with one or more of the above tests. It is important the type of tests undertaken and confirmed by the specialist are correctly recorded on the patient's receipt.
• Acknowledge that your personal information will be held by Service NSW and NSW Ministry of Health for the purpose of managing the rebate. See the privacy statement link on the rebate form.
• For the purposes of this form, you are a Specialist if you are one of the following:
  • Specialist Obstetrician and Gynaecologist
  • Specialist in Obstetric and Gynaecological Ultrasound
  • Specialist in Reproductive Endocrinology and Infertility
  • Specialist Urologist
  • Specialist Endocrinologist.

Female applicant

The rebate form can only be submitted for the rebate by the female applicant (In identifying the female applicant NSW Health acknowledges people in the transgender community, or who are non-binary, may receive fertility testing but may not identify as women). The form must be accompanied by one receipt for out-of-pocket expenses. These expenses could relate to your consultation fee or tests received by her, her partner and/or gamete donor.

• Confirm the female applicant is a resident of NSW.
• Confirm the female applicant (or her partner and/or gamete donor) is accessing fertility testing for the purpose of conceiving a child.
• Confirm the female applicant has not previously claimed the rebate and/or have not had a rebate previously claimed on her behalf.
• Inform the female applicant that her health information will be held by Service NSW and NSW Ministry of Health for the purpose of managing the rebate, and to see the privacy statement link on the rebate form.

Other patient tests

Alternately, the Female Applicant can claim the rebate using a receipt for an out-of-pocket expense incurred by a partner and/or gamete donor on a fertility test. In these circumstances the partner and/or gamete donor must also sign the Pre-IVF Fertility Testing Rebate form.

• Confirm the other patient is a resident of NSW.
• Confirm the other patient is accessing fertility testing for the purpose of conceiving a child.
• Confirm the other patient has not previously claimed the rebate and/or have not had a rebate previously claimed on his/her behalf.
• Inform the other patient that his/her health information will be held by Service NSW and NSW Ministry of Health for the purpose of managing the rebate, and to see the privacy statement link on the rebate form.
• Inform the other patient that the Female Applicant will have access to their health information by submitting the rebate form and their receipt for relevant testing, to claim the rebate.

For further information on eligibility and identification enquiries, please contact Service NSW at 13 77 88.