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.

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 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: 30 May 2024.
QC 34081