Regulations 1996 No.11 of 1996 Amendments of Work Health Regulations
Tabled Paper 2359
Tabled Papers for 7th Assembly 1994 - 1997; Tabled papers; ParliamentNT
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Work Health Regulations "FORM 4 Regulation 12(1) WORK HEALTH I WORKERS COMPENSATION MEDICAL CERTIFICATE This medical certificate is also an approved form under the Motor Accident Compensation Act (MACA) initial Certificate - up to 28 days Continuing Certificate of Incapacity - up to 3 months Medical Practitioner's name and address and phone number. Phone: I examined: (patient name and residential address) Who is/was suffering from: (please indicate whether provisional or precise diagnosis) Which the worker states was caused by: ...................... on (Date of Injury) ---/ /19 This condition is: consistent with the stated cause ___________________ not consistent with the stated ________ .________ cause - please comment__________ 2
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