Medical Certificate for Carer Payment (for a child under 16 years of age) - Extension and Reclaim of Episodic Care/Extension of Short Term Care form (SA395)

Use this form to extend short term or episodic care for a child younger than 16 you get Carer Payment for or to reclaim Episodic Carer Payment.

You must download our forms to fill them in. We have help available if you use assistive technology or if you need a translator or interpreter. Find out how to use our forms.

Download and complete the Medical Certificate for Carer Payment (for a child under 16 years of age) - Extension and Reclaim of Episodic Care/Extension of Short Term Care form.

You must reclaim Episodic Carer Payment for a child younger than 16 within 24 months from the date of both a previous assessment of care requirements and a previous treating health professional report.

This medical certificate alone is not a claim for Carer Payment or Carer Allowance.

The easiest way to claim Carer Payment, Carer Allowance or both is online. Read about claiming Carer Payment or Carer Allowance.

Page last updated: 3 December 2022.
QC 19301