Hospital Reporting and Forms

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Hospitals play an critical role in the intital treatment of a person injured in a transport accident.  Part of this involes appropriate planning to ensure the practical progress and measurable outcomes for a TAC client. We rely on this information to support the TAC client and their injury type. 

Forms for hospital providers

These forms have been formatted for you to download and use electronically.

You can open the document by clicking on the link below. You should then 'save as', giving the document a unique name (usually the client's). The required information can then be entered (typed) onto the plan and the document can be saved onto your own hard drive. When you use the forms in this way, appropriate fields expand when you are entering the information, ensuring sufficient room for text.

Discharge Planning

This assessment should be completed at least 2-3 weeks prior to discharge for all clients who have severe injuries.

Refer to the TAC's Attendant Care policy for additional information.

Equipment Prescription form
This request form is to be completed for equipment required at discharge from a rehabilitation hospital and includes wheelchairs, pressure cushions, beds, mattresses, powered conversion kits, scooters, standing frames, tilt tables, large exercise equipment, lounge chairs, custom toilet/commode/shower chairs, hoists and treatment couches.

Refer to the TAC Equipment policy for additional information.

Continence Equipment Request and Order Form:
This request form is to be completed for clients requiring continence equipment for more than 30 days post discharge. 

Refer to the TAC Equipment policy for additional information.

VPRS Discharge Summary:
When VPRS are no longer required to provide an episode of multidisciplinary rehabilitation they are required to complete and submit this form to the TAC along with a copy of the VPRS care plan.

Outpatient rehabilitation

Outpatient Rehabilitation Plan:
To be completed for all clients requiring outpatient therapy within a multidisciplinary hospital environment.. The plans must be submitted at least five working days before the program begins. Please click here to download the Notes page for the Outpatient Rehabilitation Plan.

Pain Management Program
All pain management programs require prior approval in writing and a discharge evaluation form to be completed at conclusion of the program.  Refer to the TAC's Pain Management Program policy for additional information.

Return to Work

Return to work: plan
To be completed by the therapist conducting the work site assessment. Please refer to the Return to work: plan notes for details on the information the TAC requires.

Return to work: progress report
To be completed by the therapist reviewing a return to work plan. Progress reports must be submitted five days before the current plan runs out. Please refer to the Return to work: progress report notes for details on the information the TAC requires.

Return to work: closure report
To be completed by the therapist recommending return to work plan closure. Please provide reason for closure and any ongoing considerations for the return to work as it moves forward. Please refer to the Return to work: closure report notes for details on the information the TAC requires.

TAC Claim Lodgement

How to apply for a TAC claim when the patient is in hospital.  

With permission from the patient, a hospital representative can help the patient complete the TAC Hospital Claim Form and submit the claim directly to the TAC via secure email or fax number 96569437. By completing the Hospital Claim Form, the patient is submitting a claim to the TAC to assess their entitlements. If the patient does not complete the Hospital Claim Form while in hospital but would like to lodge a claim at a later date, they can phone the TAC directly on 1300 654 329. The TAC will then make a decision about the claim and notify the patient. If the claim is accepted, the client will be allocated a TAC claim number. If you would like to discuss setting up secure email or any other matters about this process, please contact the TAC.

For more information on making a TAC claim, please refer to the following links:
Making a claim
How to claim