Pain management service: outpatient multidisciplinary assessment form

Summary:

This form is for completion by the multidisciplinary team assessing the pain management needs of a TAC client who is a hospital outpatient to help them manage their condition and reduce the disability associated with pain. The assessment takes into account the patient's physical and emotional functioning.

Coronavirus update

The TAC is unable to send or receive hard copy documents at this time. We have some different options for you to send us forms, documents or receipts for reimbursement.

Reimbursements

  • myTAC
    Please use our app or web portal, myTAC to ask for reimbursements. Go to upload documents > reimbursement form and send us a photo of your receipt or proof of payment and a description of what you've paid for.
  • Email
    If you can't use myTAC to send your receipts, please take a photo and email it to us at info@tac.vic.gov.au. Include your claim number in the subject line of your email so we can process your request.

Forms and documents

  • myTAC
    Please use our app or web portal, myTAC to send forms or documents. Go to upload documents > submit documents and send us a photo of your form or document.
  • Email
    If you can't use myTAC to send your forms or documents, please take a photo and email it to us at info@tac.vic.gov.au. Include your claim number in the subject line of your email so we can process your request.