Forms
This section provides you with a single access point for the main Comcare forms you may need to complete.
Claims forms
- Access to leave and release of Comcare payments [pdf]
- Application for gym [pdf] (SRC 239)
- Application for household or attendant care services [pdf] (SRC 19)
- Authority and consent for the release of medical information [pdf] (SRC 131)
- Cessation of employment form [pdf]
- Claim for compensation for a work-related death [pdf] (SRC 184)
- Claim for compensation for a work-related death - Employer information [pdf] (SRC 245)
- Claim for reimbursement of cost of household services [pdf] (SRC 174)
- Claim for time off work / Period of Reduced Earnings[pdf] (SRC 169)
- Claim for workers' compensation [pdf] (SRC 16)
- Compensation claim for permanent impairment [pdf] (SRC 26)
- Details of aids, appliances modifications [pdf] (SRC 171)
- Medical certificate for workers' compensation [pdf] (SRC 132)
- Medical services claim form [pdf] (SRC 67)
- Non-economic loss questionnaire [pdf] (SRC 39)
- Request to change bank account and/or personal details [pdf] (SRC 170)
- Standard PI assessment report format [doc]
Return to work forms
- Amendment to referral for rehabilitation assessment [pdf] (SRC 248)
- Medical diagnosis and prognosis [pdf] (SRC 119)
- Potential suitable duties within the work area / employer organisation [pdf] (SRC 118)
- Pre-injury work description [pdf] (SRC 117)
- Referral for rehabilitation assessment [pdf] (SRC 116)
- Return to work plan - Amendment [pdf] (SRC 86)
- Return to work plan - Closure [pdf] (SRC 41)
- Return to work plan [pdf] (SRC 40)
- Work trial agreement [pdf] (SRC 64)
Plant safety forms
Major hazard facility forms
Dangerous goods and explosives forms
Agency update forms
- Agency update forms completion guide [pdf]
- Case manager data updates [pdf] (or RTF version)
- CIS access request form [pdf] (or RTF version)
- Comcare new customer creation [pdf] (or RTF version)
- Cost centre update form [pdf] (or RTF version)
