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Detail Confirmation Form

Please fill out the form below

(for the account we deduct your premiums from)

Member Declaration : 

I/we understand that I have given RT Health (ABN 93 087 648 744, user id number 018015) permission to debit my nominated credit card/bank account

I/we have authorised RT Health to debit our nominated account for payment of contributions and to vary the amount of the debit as necessary for changes to cover or contributions



Confirm your details by selecting yes in the box above. Thank you!

You can find a copy of the Direct Debit Service Agreement here: Link to

Direct-Debit-Request-Service-Agreement-2022-August-2022.pdf (rthealthfund.com.au)