Search Results
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[PDF] ROI Application Form for Lawyers v1.0
25 Mar 2025: RELEASE OF INFORMATION (ROI): SOLICITORS. Page 1 of 1. Important notes. This form assists solicitors to request copies of information held on a TAC claim of a client they represent, in accordance with the TAC’s Release of Information (ROI) Policy.
https://www.tac.vic.gov.au/providers/…I-Application-Form-for-Solicitors.pdf
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[PDF] Bournemouth Back
24 Mar 2020: BACK BOURNEMOUTH QUESTIONNAIRE. Patient Name ________________________________________________ Date ___________________________ Instructions: The following scales have been designed to find out about your back pain and how it is affecting you. Please
https://www.tac.vic.gov.au/providers/working-with-the-tac/outcome-measures
/musculoskeletal-measures/Back-Bournemouth-Questionnaire.pdf -
[PDF] Bournemouth Neck
24 Mar 2020: NECK BOURNEMOUTH QUESTIONNAIRE. Patient Name ________________________________________________ Date ___________________________ Instructions: The following scales have been designed to find out about your neck pain and how it is affecting you. Please
https://www.tac.vic.gov.au/providers/working-with-the-tac/outcome-measures
/musculoskeletal-measures/Neck-Bournemouth-Questionnaire.pdf -
[DOC] Hospital Direct Equipment Order Form
15 Nov 2023: Hospital Direct Equipment Order Form. PAGE 6. Hospital Direct Equipment Order Form. PAGE 7. Important notes. This form can be used to order basic equipment items directly from the listed TAC Equipment Contractors to facilitate a patient’s safe
https://www.tac.vic.gov.au/providers/…ital-Direct-Equipment-Order-Form.docx
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[DOC] TEACHER ACCOUNT
24 Jul 2012: education support services:. teacher account. Privacy. The TAC will retain the information provided and may use or disclose it to make further inquiries or assist in the ongoing management of the claim or any claim for common law damages. The TAC
https://www.tac.vic.gov.au/providers/documents-and-forms/basic-forms
/integration-support-teacher-account-form/ikf7.doc -
[DOC] Important notes for completing the treatment notification plan
29 Mar 2022: PROSTHETICS Treatment request form. PROSTHETIC Treatment request form. Page 3. This form is used to request prosthetic treatment for TAC clients and WorkSafe workers. The information in this form is for use by the organisation which has requested it
https://www.tac.vic.gov.au/providers/documents-and-forms/basic-forms
/prosthetics-treatment-request-form/TAC-Prosthetics-Treatment-Request.docx -
Sheet1
28 Apr 2023: TAC Claim number. Client Name. Date referral received. Name of referring hospital. Referral status. Reason not accepted. Date of referring provider informed of referral decision. Date of initial client contact. Date initial ax form sent to TAC. Date
https://www.tac.vic.gov.au/providers/working-with-tac-clients/guidelines
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[DOC] Important notes for completing the treatment notification plan
12 Aug 2009: pharmacy:. erectile dysfunction questionnaire. pharmacy:. erectile dysfunction questionnaire. Your patient’s privacy. The TAC will treat the information requested as confidential and will use the information in this questionnaire for the purpose
https://www.tac.vic.gov.au/providers/documents-and-forms/basic-forms
/pharmacy-erectile-dysfunction-questionnaire/phf30.doc -
[DOC] Pharmacy Opioid Management Plan
23 Apr 2021: ABN 22 033 947 623. Address TAC, Reply Paid 2751, Melbourne, VIC 3001. Telephone 1300 654 329. Email info@tac.vic.gov.au. DX 216079, Melbourne. Website tac.vic.gov.au. App. Claim number. Date of accident. Date of birth. / /. / /. Patient’s name.
https://www.tac.vic.gov.au/providers/documents-and-forms/basic-forms
/opioid-safety-and-management/TAC-Opioid-Safety-Check.docx -
MBS TAC Reimbursement Rates for Medical Services Rates effective ...
2 Apr 2024: TAC Reimbursement Rates for Medical Services. Rates effective 1 July 2023 (unless otherwise listed). All rates have been indexed effective 1 July 2023 unless stated otherwise as New, Amended or Ceased. CMBS Item No. TAC Rate. Version Change Detail.
https://www.tac.vic.gov.au/providers/…ite-version-2023_2024v5-20240401.xlsx