Consent to disclose medical information form (SA472)
Use this form to confirm that you consent to your treating health providers disclosing relevant information about your disability or medical conditions to us.
Download and complete the Consent to disclose medical information form.
This form is used to support your claim for Disability Support Pension form.
A translated version of this consent form may be available in your language.
This PDF is fillable. You can fill it out on your device, or print it and complete it by hand.
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: 8 December 2020
This information was printed 18 June 2021 from https://www.servicesaustralia.gov.au/individuals/forms/sa472. It may not include all of the relevant information on this topic. Please consider any relevant site notices at https://www.servicesaustralia.gov.au/individuals/site-notices when using this material.