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Application for a lung disease examination
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In using this online facility you acknowledge:
the information and documents provided will form part of the records of the claim you have specified (only attach relevant documents)
the information provided and documents submitted are true and correct
your obligations under the
Workers Compensation and Rehabilitation Act 2003 and Regulations
any personal information about you or others has been provided with consent and will be collected, stored, and disclosed in accordance with our
Privacy and Security Statement
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Privacy Policy
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Acknowledgement
In using this online facility you acknowledge:
the information provided and documents submitted are true and correct
your obligations under the
Workers Compensation and Rehabilitation Act 2003 and Regulations
any personal information about you or others provided will be collected, stored, and disclosed in accordance with our
Privacy and Security Statement
and
Privacy Policy
.
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