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Authority and consent for the collection and release of medical information pertaining to my claim

Summary

Comcare needs to collect your personal information for the purpose of determining and managing your compensation claim and to assist Comcare in the performance of its functions and exercise its powers under the Safety, Rehabilitation and Compensation Act 1988 (SRC Act). This form is used to collect that information.

Available formats

Below is a completed sample of this form.

Last updated: August 2018

If you would like to request this publication in a different format to what is available for download (above), or the publication is not currently available for download, please refer to:

Page last updated: 08 Aug 2018