Statutory Declaration Run-off Cover Indemnity Scheme - Midwife aged 65 years of age or over who has ceased practice form (MO039)

The midwife completing this statutory declaration must have been aged 65 years of age or over and must have permanently ceased private practice as an eligible midwife (apart from the provision of free medical services) as at the notification date on which the insurer was first notified of a run-off claim made against the midwife, or an incident that may have given rise to a run-off claim against the midwife.

 

Page last updated: 8 June 2016

This information was printed Tuesday 27 September 2016 from humanservices.gov.au/health-professionals/forms/mo039 It may not include all of the relevant information on this topic. Please consider any relevant site notices at humanservices.gov.au/siteinformation when using this material.