Service provider registration application medical and allied health services

• Service provider registration application medical and allied health services (PDF 49kb)
  Document Type: Form
  Keycode: FOR547/04/06.04
  Category: Health Care Providers 
  Publication Date: 11 October 2006
  Date First Published: 11 October 2006
  Summary: This form is used to register as a provider of medical and allied health services to WorkSafe claimants.

About this form

A provider of reasonable medical and like services to WorkCover claimants must satisfy the relevant qualification requirements in the appropriate discipline.

Where to send the form

Victorian WorkCover Authority Rehabilitation & Medical Services GPO Box 4306 MELBOURNE VIC 3001 Telephone Number (03) 9641 1626 (03) 9641 1615 Fax Number (03) 9641 1767