Medicolegal Referral Form

By submitting the referral form below, you acknowledge that you have been provided with instructions to schedule and proceed with a medicolegal assessment. If you would like to discuss the matter before scheduling an appointment, please feel free to contact our medicolegal team at 02 4208 0160.

  • Referrer Details

  • Clients Details

  • This will only be used to confirm the appointment and address. (Mobile preferred)
  • This will only be used should the assessment take place via video conference due to COVID-19
  • Please note our report turnaround is 3-4 weeks from date of assessment.
  • It is the referrer’s responsibility to organise an accredited interpreter to be present for the assessment if one is required.(Must be certified with Accreditation Authority for Translators and Interpreters; family members or friends cannot be used)
  • Please note: In order to conduct the assessment, hard copies of the letter of instruction and medical documents must be sent via registered or express post to PO Box 4303, Shellharbour, NSW 2529 no later than two weeks prior to the scheduled appointment date. (Please email the tracking number to admin@moorerehab.com.au when sent).

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