ACC SENSITIVE CLAIMS

IMPORTANT

 

This form needs to be filled in by an ACC Sensitive Claims Service (SCS) Lead Provider.

If you are an individual wanting to refer yourself or a friend/family member, do not fill this form in. Please send your Lead Provider the information about Revive and ask them to refer you.

If you have any questions or issues, please let us know (office@adventurespecialties.co.nz att: Anneke)

IMPORTANT

 

This online form takes roughly 30-40 minutes to fill in.

If you can’t complete the form in one sitting: the form should retain your answers (if you continue to use the same device and browser).

If there are any issues, please contact us (office@adventurespecialties.co.nz att: Bex)

 

If there are any issues with this form, please contact our website person (office@adventurespecialties.co.nz attention: Bex)