Transcription of IPTAAS Claim Form - EnableNSW
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IPTAAS Claim Form - EnableNSW
IPTAAS Registration ELIGIBILITY DETAILSHave you claimed, or are you entitled to Claim , travel and/or accommodation benefits from any of the following:1. Any Australian, State or Territory government scheme other than IPTAAS ?2. As part of a Workers Compensation Claim ?3. As part of any insurance Claim ?4. Do you have a Veterans Affairs (DVA) Gold Card?YesNoYesNoYesNoYesNoIf you are uncertainabout your eligibilityplease contact yournearest IPTAASO ffice to confirmAlternate contact person detailsNamePhone PATIENT DETAILSE mail addressDaytime phone numberMobile numberResidential addressPostcodePostal addressPostcodeAre you Aboriginal/Torres Strait Islander?
IPTAAS Registration number 1.1 ELIGIBILITY DETAILS Have you claimed, or are you entitled to claim, travel and/or accommodation benefits from any of the following:
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