Download and complete the Run off Cover Indemnity Scheme - medical certificate permanent disability form.
Use this form if the medical practitioner has temporarily or permanently ceased from providing medical services due to permanent disability.
A medical practitioner other than the medical practitioner being assessed for eligibility under the ROCS must complete this form.
ROCS is the Run off Cover Indemnity Scheme.
To fill in this form digitally you will need a computer and Adobe Acrobat Reader, or a similar program. You can download Adobe Acrobat Reader for free. If you can’t complete the form digitally, you can print it, complete it by hand and return it to us following the instructions on the form.
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 contact us. We can help you access, complete and submit them.