List of SIRA forms
Use this page to find SIRA forms by scheme.
Workers compensation forms
A
- Allied health recovery request (interactive)
- Allied health recovery request (word version)
- Allied health practitioner application for SIRA Workers Compensation approval (interactive)
- Allied health practitioner application for SIRA Workers Compensation approval (static)
- 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)
- Commutation application
- Continuation of weekly payments after 130 weeks application
D
E
H
- Hearing service provider application for SIRA approval (interactive)
- Hearing service provider application for SIRA approval (static)
I
- Independent consultant application
- Independent consultant referral
- Injury management consultant and authorised health practitioner form
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
- Self insurance: significant matters notification
- Standard consent form for release of personal information
- 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 - interactive PDF
- Allied Health Recovery Request - Word document
- Application for special assessment of procedural claims disputes
- Application for a referral to MAS by a claims assessor or court
- Application for general assessment
- 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)
- Compensation to relatives claim
- Compensation to relatives claim - statutory declaration
E
- Equipment request
- Exemption for a compensation to relatives claim
- Exemption for a personal injury claim
- Extra document information form
F
- Further assessment of a permanent impairment dispute
- Further assessment of a treatment dispute
- Further general assessment
M
- Motor accident personal injury claim (interactive PDF)
- Motor accident personal injury claim (static PDF)
N
P
R
- Rehabilitation services (interactive PDF)
- Rehabilitation services (static PDF)
- Reply to an application for assessment of permanent impairment dispute
- Reply to an application for assessment of treatment dispute
- Reply to an application for exemption of a compensation to relatives claim
- Reply to an application for exemption of a personal injury claim
- Reply to an application for further assessment of permanent impairment dispute
- Reply to an application for further assessment of treatment dispute
- Reply to an application for general assessment
- Reply to an application for referral to MAS by a claims assessor or court
- Reply to an application for review of a medical assessment
- Reply to further general assessment
- Reply to special assessment application
- Review of a medical assessment
S
T
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)