List of SIRA forms
Use this page to find SIRA forms by scheme.
Workers compensation forms
A
- Allied Health Treatment Request
- Allied health practitioner application for SIRA Workers Compensation approval (interactive)
- Allied health practitioner - request to withdraw
- Application for approval of pre-injury average weekly earnings agreement
- Application to endorse or delete a subsidiary on a self-insurer licence
- Application for workers compensation insurance claims, policy and settlement records
- Application to renew a specialised insurer licence (interactive)
- Application to renew a self insurance licence
- Application for a self-insurer licence
C
- Calculating pre-injury average weekly earnings
- Certificate of capacity
- Certificate of capacity - treating physiotherapists and treating psychologist
- Certificate of capacity - treating physiotherapists and treating psychologist (interactive)
- Checklist for Insurers - Risk factors for delayed recovery and RTW – full version
- Checklist for Insurers - Risk factors for delayed recovery and RTW – short version
- Commutation application
- Continuation of weekly payments after 130 weeks application
D
E
H
- Hearing service provider application for SIRA approval
- Health practitioners authorised to give evidence - initial application
- Health practitioners authorised to give evidence - renewal application
I
- Independent consultant application
- Independent consultant referral
- Injury management consultant - initial application
- Injury management consultant - renewal application
J
N
O
P
- Permanent impairment assessor application
- Permanent impairment claim
- Permanent impairment claim - exempt claimants
- Pre-injury average weekly earnings form
- Pre-injury average weekly earnings form - post 21 October 2019
R
- Request for replacement hearing aid
- Return to work assistance training application
- Review form - application for review by the insurer
S
- Self insurance: application to endorse or delete a subsidiary on a self-insurer licence
- Self insurance: application to renew a self insurance licence
- Self insurance: application for a self-insurer licence
- Sample form for obtaining/releasing personal information
- SIRA workers compensation treating allied health practitioner approval application
- Subcontractor's statement
T
V
- Vocational program - claim for payment
- Vocational program - closure report
- Vocational program - details
W
Motor accident (CTP) forms
For accidents before 1 Dec, 2017
A
- Agreed goals for rehabilitation
- Allied Health Recovery Request - instructions
- Allied Health Recovery Request - interactive PDF (open in Internet explorer)
- Allied Health Recovery Request - Word document
- Attendant care request - interactive PDF (open in Internet explorer)
C
- Certificate of earnings
- Certificate of fitness
- Certificate of fitness- treating physiotherapists and treating psychologist
- Certificate of fitness- treating physiotherapists and treating psychologist (interactive) (open in Internet explorer)
E
- Equipment request (static PDF)
- Equipment request - interactive PDF (open in Internet explorer)
- Equipment request (word document)
N
R
- Rehabilitation services (static PDF)
- Rehabilitation services - interactive PDF (open in Internet explorer)
S
For accidents on or after 1 Dec, 2017
A
- Agreed goals for rehabilitation
- Application for damages under common law
- Application for funeral expenses
- Application for personal injury benefits
- Application to compensate relatives
- Attendant care request
C
- Certificate of earnings
- Certificate of fitness
- Certificate of fitness - treating physiotherapists and treating psychologist
- Certificate of fitness - treating physiotherapists and treating psychologist (interactive)
- CTP Programs to Support Recovery at Work – Reimbursement Form
- CTP Programs to Support Recovery at Work - Application Form
D
E
- Equipment request - (static PDF)
- Equipment request - (interactive PDF) (open in Internet explorer)
- Equipment request - (word doc)
N
R
- Rehabilitation services (static PDF)
- Rehabilitation services (interactive PDF) (open in Internet explorer)