Information if you're affected by coronavirus (COVID-19).
Specific Injury Questionnaire
Form ID:
D1381
Audience:
General
This is a questionnaire to assist in claiming compensation or disability pension if a specific injury or trauma has been experienced.
If you are using an Apple computer and want to fill out your form electronically, please download the form and open it with Acrobat 7 or later.
How can I access this form?:
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