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

This information was printed Saturday 1 October 2016 from humanservices.gov.au/health-professionals/forms/mo043 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.