Get Au Dhs Mo021 2020-2025

Filling out the AU DHS MO021 form is a vital step for individuals seeking compensation due to injury or illness. This guide will provide you with clear instructions to complete the form efficiently and accurately.

Follow the steps to complete the form successfully

1. Click 'Get Form' button to obtain the form and open it in the editor.
2. Start by providing the Medicare compensation case reference number, if known. This number is essential for processing.
3. Indicate whether the injured person is listed on a Medicare card by selecting 'Yes' or 'No'.
4. Fill in the injured person's details, including their Medicare card number and personal information such as their name, date of birth, and contact information.
5. Confirm if this form is being completed on behalf of an injured person who is under 14 years of age, lacks capacity, or is deceased by answering 'Yes' or 'No'.
6. Provide details for the authorized third party, including their name, relationship to the injured person, and contact information.
7. Complete the claimant's details section, mirroring the earlier steps for the injured person's information.
8. Read the privacy notice carefully and ensure that all required sections are answered to avoid processing delays.
9. Sign and date the declaration section as the injured person or claimant, confirming the information is accurate.
10. If applicable, have the authorized third party also sign and date their declaration, confirming their role.
11. Review the form for completeness and accuracy. Once finalized, you can save, print, or share the form as needed.

Complete the AU DHS MO021 online and ensure your compensation claim is processed without delay.