Consent to disclose medical information form (SA472)

Use this form to confirm that you consent to your treating health providers disclosing relevant information about your disability or medical conditions to us.

This form is used to support your claim for Disability Support Pension form.

A translated version of this consent form may be available in your language.

This PDF is fillable. Download this form and complete it on your device, or print it and complete it by hand.

If you use assistive technology because of a disability or impairment we provide help for assistive technology users of forms.

Page last updated: 11 October 2017