Request for medical information form (CS4597)

Use this form to provide proof to support a request to change a child support assessment.

Only a medical practitioner can complete this form and it is voluntary.


If you have a disability or impairment and use assistive technology, there are other ways you can do your business with us. You can use self service or request someone to deal with us on your behalf. If you can’t access our forms, please contact us. We can help you access, complete and submit them.

Page last updated: 9 April 2018