Important: Please download this PDF to your computer. You can fill it in using Adobe Reader but it will not save if you attempt to fill it in using your web browser.
Published:17 Aug 2022
File size:589.47 kB
What it contains
Complete this form once the injured worker has signed and returned their program consent form. Case managers should complete and send the supplementary information form to the nominated support coordination provider.
The case manager should then follow up with an informal discussion with the nominated support coordination provider. This discussion aims to align both parties in their approach to the support coordination service and help identify additional documentation required in developing an injured worker’s Person-Centred Plan (PCP).