Support Coordination Program: Supplementary information form

This form provides background information about the eligible injured worker to the support coordination provider.

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What it contains

Complete this form once the injured worker has signed and returned their program consent form. Case managers should complete and send the supplementary information form to the nominated support coordination provider.

The case manager should then follow up with an informal discussion with the nominated support coordination provider. This discussion aims to align both parties in their approach to the support coordination service and help identify additional documentation required in developing an injured worker’s Person-Centred Plan (PCP).