Verification of medical conditions form (SU684)

Use this form to verify medical conditions affecting your capacity to work if you need an Employment Services Assessment.

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 Verification of medical conditions form.

A medical practitioner must complete this form.

This is not a medical certificate. If you are seeking a temporary exemption from your Mutual Obligation or participation requirements because you are temporarily incapacitated for all work your treating doctor needs to complete a Medical Certificate.

Page last updated: 9 October 2024.
QC 19796