Medical Forms

Medical Certificates

Medical certificates are available in two formats:

1. Standard PDF-to print and complete by hand
2. Microsoft Word- to complete and save electronically, and to print out

The Word version looks different to the PDF version but contains the same information. It can be downloaded by users and saved electronically in your systems. This means you can:

  • complete the certificates on your computer and save them in your own file;
  • print the completed version, sign and submit it the injured worker

    Please email postmaster@workcover.wa.gov.au if you have any difficulty using the certificates.


    • First Medical Certificate
    Word Version, 1 page

    PDF Version - 250KB, 1 page

    Progress Medical Certificate
    Word Version, 1 page
    PDF Version - 186KB, 1 page

    Final Medical Certificate
    Word Version, 1 page
    PDF Version - 172KB, 1 page


    Rehabilitation Referral Form

    Vocational Rehabilitation Referral Form PDF Version - 1104KB, 1 page

    Regulated Forms

    Form 6 - Declaration in Respect of Worker Not Residing in WA, 1 page

    Form 7- Interim Payment of Statutory Entitlements, 1 page

    Approved medical specialist Forms

    Click here for the full list of ams forms



    		 

    Publications

    Approved Medical Specialists A Guide for Doctors

    Related Links

    Injury Management Overview

    General Practitioners Overview

     

    Related Pages

    Medical Forms Injury Management Forms Noise Induced Hearing Loss Forms DRD Regulated Forms Forms Dispute Resolution Directorate Approved Forms 1 - 10A Claim/Worker Forms Dispute Resolution Directorate Approved Forms 11 - 24 Frequently Asked Questions - DRD Approved Forms Consent Forms Registered Agent Forms Common Law Forms Employer Forms

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