Statutory declaration ROCS - deceased medical practitioner form (MO033)

Use this form if you need to declare for the purpose of ROCS where a valid death certificate is not available to support eligibility.

The ROCS only applies to claims or incidents first notified on or after 1 July 2004.

ROCS is the Run off Cover Indemnity Scheme.

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

Page last updated: 10 April 2019