Statutory Declaration ROCS - Midwife engaged in a private practice form (MO044)

Use this form if you are a midwife that has not been engaged in private practice at any time in the 3 years preceding the date a run-off claim was made against you.

This statutory declaration should be completed by a midwife on or after the notification date.

Midwife Professional Indemnity Run-off Cover only applies to a claim or incident on or after 1 July 2010.

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: 27 August 2017