Run-off Cover Indemnity Scheme for Midwife Medical Certificate for maternity or permanent disability form (MO043)

Complete this form if a Professional Indemnity Insurer (PII) has determined that an insured midwife is eligible to participate in the Midwife Professional Indemnity (Commonwealth Contribution) Scheme for Run-off Cover. This form must be completed by a medical practitioner for the midwife who is being assessed for eligibility under Run-off Cover.

Page last updated: 8 June 2016

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