Statutory declaration ROCS - Midwife who has ceased practice form (MO041)

Use this form if you are a midwife that has temporarily or permanently ceased midwifery practice because of maternity as at the date a run-off claim was made against you.

You must download our forms and fill them in so they are processed quickly. You can also electronically sign some of our forms. We have help available if you use assistive technology.

Download and complete the Statutory declaration ROCS - Midwife who has ceased practice form.

This statutory declaration should be completed by a midwife on or after the notification date.

Midwife Professional Indemnity Run-off Cover only applies to a claim or incident first notified on or after 1 July 2010.

ROCS is the Run-off Cover Indemnity Scheme.

Page last updated: 17 November 2022.
QC 21541