This form is no longer available.
If you're claiming for an isolation, quarantine or caring period on 17 January 2022 or earlier, you must call the Emergency information line. Let us know if you need an interpreter and we’ll arrange one for free.
If you're claiming for an isolation, quarantine or caring period starting from 18 January 2022 onwards, you must claim online. Read more about how to claim online.
You can call us on 180 22 66 if you need to make a claim on 17 January 2022 or earlier.
If you have a disability or impairment and use assistive technology, you may not be able to access our forms. If you can’t, please use self service, request someone to deal with us on your behalf, or contact us. We can help you access, complete and submit them.
Page last updated: 22 February 2022
This information was printed 3 July 2022 from https://www.servicesaustralia.gov.au/em252. It may not include all of the relevant information on this topic. Please consider any relevant site notices at https://www.servicesaustralia.gov.au/site-notices when using this material.
