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Digital Tool Prompts
ACC6300 – Authority to Collect Medical and Other Records
This form authorizes ACC to collect medical and other relevant records related to your claim. It ensures ACC can process your claim efficiently by accessing necessary information from third parties like healthcare providers and employers.
Allows ACC to gather medical and employment records.
Ensures compliance with the Privacy Act 2020.
Helps determine eligibility for compensation and rehabilitation.
Can be submitted via email or mail.
Download ACC6300 – Authority to Collect Medical and Other Records
ACC5937 – Authority to Act Form
This form allows you to authorize someone to act on your behalf when dealing with ACC. It grants permission for your nominated person to access your claim details and communicate with ACC regarding your case.
Authorizes someone for specific or all ACC claims.
Allows access to claim information via phone, email, and mail.
Can be revoked anytime by notifying ACC.
Requires personal and nominee details before submission.
Download ACC5937 – Authority to Act Form
ACC253 – Request for Prior Approval: Transport and Accommodation Assistance
This form is used to request approval for transport and accommodation support when attending medical treatment or rehabilitation due to an ACC-covered injury.
Requires medical confirmation for support eligibility.
Can be completed by the claimant, a family member, or a case manager.
Covers air travel, accommodation, and other transport options.
Includes support for escort and accompanying persons.
Download ACC253 – Transport and Accommodation Assistance Form
ACC709 – Customer Complaint Form
If you are dissatisfied with ACC’s services, you can submit a formal complaint using this form. It allows ACC to review and address concerns regarding your experience.
Requires details of the complaint and involved parties.
Allows submission via email, mail, or phone assistance.
Requests information on the resolution you are seeking.
Can be submitted by a representative on your behalf.
Download ACC709 Customer Complaint Form
ACC1 – Request for Assistance Form
This form is for individuals who need additional support beyond medical treatment due to an injury. It ensures ACC can assess and provide the appropriate assistance.
Requires claimant details, claim number, and contact information.
Covers medical treatment, rehabilitation, and earnings compensation.
Needs supporting documents like medical certificates or receipts.
Must be signed and submitted via email or mail.
Download ACC1 Request for Assistance Form