Insurance forms
Insurance forms
You'll need to complete the Insurance Application and Personal Health Statement if your insurance has not been accepted under an Automatic Acceptance Limit agreement and you therefore need to be individually underwritten.
If you have any queries in relation to any of these forms please contact our client services team on 1800 333 900.
You will need Adobe Acrobat Reader to view these files.
| Asthma, Bronchitis, Sleep Apnoea or Respiratory Condition questionnaire | PDF File | (82.4 KB) |
| Bankruptcy questionnaire | PDF File | (65.7 KB) |
| Chest Pain questionnaire | PDF File | (87.8 KB) |
| Confidential Lifestyle questionnaire | PDF File | (61.6 KB) |
| Depression, anxiety, stress, chronic fatigue questionnaire | PDF File | (100.8 KB) |
| Drug Use questionnaire | PDF File | (63.6 KB) |
| Financial questionnaire | PDF File | (97.0 KB) |
| General Medical Condition questionnaire | PDF File | (71.1 KB) |
| Health Declaration | PDF File | (84.3 KB) |
| Insurance Application & Personal Health Statement - Form F | PDF File | (440.9 KB) |
| Lump, Skin Lesion, Cyst, Growth or Mole questionnaire | PDF File | (66.6 KB) |
| Medical Evidence Authority | PDF File | (39.5 KB) |
| Medical/Pathology Request | PDF File | (66.3 KB) |
| Musculoskeletal or Joint Condition questionnaire | PDF File | (80.6 KB) |
| Occupational Duties Questionnaire & Smoker Declaration | PDF File | (88.2 KB) |
| Sports and Pastimes questionnaire | PDF File | (84.6 KB) |
