Follow the steps to successfully complete the form

1. Click the ‘Get Form’ button to obtain the form and open it in your preferred editing tool.
2. Part A must be completed by the person issuing the form. Ensure you provide the name of the doctor and their practice location for the applicant to take during their medical examination.
3. In Part B, the applicant needs to fill in personal details such as surname, first names, address, suburb, APBA Licence Number, SBA Licence Number, date of accident or illness, and the location. Ensure all fields are accurately populated.
4. Indicate whether you have suffered an accident, illness, or disability by selecting the appropriate options. Additionally, provide a detailed description of the nature of your accident, disability, or illness in the space provided.
5. Respond to the questions regarding treatment by selecting 'Yes' or 'No' and provide the name of the hospital or doctor if treatment was administered. Describe any injuries sustained during the accident.
6. The applicant must assess their recovery by selecting 'Yes' or 'No' regarding their fitness to ensure safety for themselves and other competitors.
7. The applicant should sign the form and include the date to grant permission to the medical practitioner to access their medical records.
8. Part C requires completion by the medical practitioner who will certify the applicant’s fitness to race. This section includes space for the practitioner’s signature, date, name in block letters, and qualifications.
9. After completing all sections, make sure to save your changes. You can also download, print, or securely share the form as needed.

Complete and submit your forms online to ensure a seamless process and timely approval.