Provider web directory update form

Date of effect:

As a Comcare Approved Rehabilitation Provider your details are provided on the Comcare ARP Directory . The directory is a place where rehabilitation authorities can find you. If you are approved in more than one state/territory then complete a form for each one.

State:

(Provider name)*
ABN *
Provider Number *
Contact*
Postal address
Phone: Prefix Number
Fax
E-mail*
Website
Geographic cover
Occupational rehabilitation services provided (insert relevant services from pick list below) Return to work case management Worksite assessments Functional capacity evaluations Vocational assessments Injury management education Vocational/disability counselling Incident reporting and management Job search
Particular Areas of Interest/Expertise

* Indicates mandatory fields.

Allow 10 days for changes to be published.

Email this form to rehab.approval@comcare.gov.au OR fax to 02 6274 8689 OR phone Gillian Clarke or Jane Kirk on 1300 366 979

Page last updated:December 4, 2007