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Contact Details

Victoria

T: 03 9017 2575
F: 03 9017 2579

NSW / ACT / Queensland

T: 02 9518 9513
F: 02 9571 7293

E: info@injurytreatment.com.au

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Worker Details

Surname
Title
First Name
Address
Email
Phone Number
Home
Work
Date of Birth
Interpreter Required
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Language
Occupation

Employer

Company
RTW Coordinator
Supervisor/Manager
Address
Phone
Fax
Email

Insurer

Company
Contact
Claim Number
Address
Phone
Fax
Email

Injury Details

Date of Injury
Injury

Injury Details

Name
Phone
Fax
Address

Service(s) Required

Case Management Services Same Employer Workplace Assessment - one off Initial Assessment - one off Ergonomic Assessment - one off Develop RTW Plan - one off Activait Tail Management Program Functional Assessment Group Training (eg. manual handling / ergonomics / safety) Psychological Treatment Services Home Assessment / ADL Assessment Medical Case Conference Optimise Functional Treatment Program Assessment

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