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These forms are for self-employed individuals, businesses (of all sizes), tax agents, accountants, advisors and shareholder employees; These forms are for healthcare providers and …

As a registered provider, you can lodge claims on behalf of your patient if you think they have an injury we cover. You'll need to check you're lodging the right type of claim, and following the …

Complete this form to request ACC to reimburse expenses associated with your travel to ACC funded treatment and rehabilitation.

Complete this form to request and validate ongoing treatment on behalf of a patient, or to request an alteration in diagnosis. The request must relate to an injury that has an accepted ACC …

• The ACC45 or ACC42 form can be lodged electronically or manually. • Please email, fax or post the ACC2152 form and clinical notes to: ACC Treatment Injury Centre, PO Box 430, Dunedin …

Complete this form to request help with the cost of your prescriptions. When you’ve finished, please return this form to the address on the enclosed information sheet. If you need any help …

ACC forms. Concussion service. Referral guide Referral form. Gradual Process questionnaire (ACC271) Lump sum payment (ACC554) Prescription reimbursement (ACC249) Pain services …

It is a claim to ACC to cover an injury caused to a patient by treatment from a Registered Health Professional. The claim must be lodged with the consent of the patient. When an injury is …

The ACC form has patient details, and claim details. If the form was emailed from SubmitKit, the patient details will be completed, and the patient will also be able to save the progress of …