Free Clinical Review of Your Injury

Understand your recovery and what to do next

Tell us about your injury and recovery

Your information is confidential
The information you provide will be handled securely and confidentially by Medicess and used to review your injury, treatment and recovery. For more information about how we use and protect your personal information, please see our Privacy Policy.

Medicess Patient Injury Review Form

  • About You
  • Your Details
  • Injury and Recovery
  • About the Accident
  • Documents and Consent

This form may take 10 to 15 minutes to complete.

You can save your progress at any time and return later using a secure link that will be sent to your email address.


YOUR INFORMATION


Unfortunately, we cannot proceed with a Patient Injury Review without the injured person's permission or appropriate authority to act on their behalf.

If the injured person is able to provide consent, please ask them to complete the form themselves or contact us to discuss their circumstances.

What Happens Next?

Tell us about your injury, treatment, recovery and how it is affecting your everyday life.  You can also upload relevant medical documents if you have them.

Our doctor-led clinical team reviews the information you provide and considers your injury, treatment and current recovery.

We’ll send you a free written review explaining our findings and what we think you should consider doing next.

If we believe Medicess may be able to support your recovery, we’ll contact you to discuss your circumstances, the options available and what could happen next.