Workcover / TAC Form

Workcover Details

Insurance Company*

Claim Number*

Case Manager*

Phone*

Email address*

Employer

Address

Street Address Line 1*

Street Address Line 2

Suburb/City*

State*

Postcode*

TAC Details

Claim Number

Date of Accident

*PLEASE NOTE: If you are a Workcover or TAC patient, you must provide your claim number and all relevant documents to confirm your claim acceptance. *All consultations fees must be paid in full on the day, and we will provide you with a receipt for you to claim reimbursement from Workcover or TAC. If you require any paperwork to be completed/signed by the surgeon (including certificates of capacity) this needs to be completed during your consultation.*

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Contact Form

Workcover Details

Address

TAC Details

How to find Melbourne Arm Clinic

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