Medical Release Form

I am aware that as part of the assessment, treatment and reporting process, my Smart Health practitioner may need to release personal information to, or obtain information relating to my injury from, my Doctor, other Health Professionals, Injury Management professionals and representatives of my Employer.

By completing this authority, I am granting Smart Health Training & Services unqualified permission to obtain and release information to my Employer and other Health Professionals who are assisting with my recovery.

Worker’s Authority:

I hereby authorise Smart Health Training & Services to obtain and release all relevant medical information about my injury to assist with my recovery and return to work, to representatives of my Employer and other Injury Management Professionals whoare assisting with my recovery. 

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