Provider forms

Provider Forms

Authorisation to Release Information Form

Use this form to authorise the release of the patient and member’s details by the patient’s doctors, hospitals and any other authorities to CBHS Corporate Health and CBHS Corporate Health’s medical consultants. The patient (or member if the patient is a dependent on their parent’s membership) must sign the form for the authorisation to take effect.

Certificate for Medical Practitioner

Members may need to submit this form if they have joined or upgraded their level of hospital cover in the past 12 months. This medical report allows CBHS Corporate Health’s medical advisors to check whether the member’s condition is a pre-existing condition and determine whether it is covered by the member’s cover.

Accident/Injury/Condition Form

The Accident/Injury/Condition Form allows CBHS Corporate Health to access the member’s claim in relation to an accident, injury or condition. You’ll need to outline the nature of the injury or condition and provide other relevant details such as date of occurrence and whether the injury occurred at work. 

Hospital Special Consideration Forms

On some occasions, CBHS Corporate Health may need to obtain information directly from providers such as hospitals, doctors and other health professionals. These are the forms used for HELPER registration, hospital payments, hospital special consideration, information release authorisation, medical practitioner certificates and accident/injury/condition forms.