Answer what you can. Every question here is optional.
How did the injury occur, and what injuries did you suffer?
What kind of work injury is it?
Have you reported this to your employer?
Select...
Yes
No
Not Sure
Are you still working?
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Yes, full duties
Yes, modified duties
No, off work
Employment terminated
Have you lodged a WorkCover claim?
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Yes
Not yet
Not sure
Your role in the accident
Brief description of accident
Was it reported to police?
Select...
Yes
No
Not Sure
What happened?
Select...
Slip and Fall
Trip and Fall
Falling Object
Assault
Other
What happened, and what injuries did you suffer?
Did you get medical treatment?
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Hospital/Emergency
Doctor/GP
Ambulance called
No treatment yet
Did you report it to anyone?
Select...
The owner or operator
Police or council
Not reported
Not sure
Where were you treated?
Select...
Public Hospital
Private Hospital
Medical Clinic/Practice
Aged Care Facility
Other
What treatment were you having, what went wrong, and what happened as a result?
Which of these is your claim about?
Have you already made a claim?
Select...
Yes
Not yet
Not sure
What happened, and what are you claiming for?
Where did it happen?
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Cruise ship
Boat or watercraft
Aircraft
Airport or terminal
Bus or coach
Train
Hotel or resort
Tour or excursion
Other
Did it happen overseas?
Select...
Yes
No
What happened, and what injuries did you suffer?
Activity
Select...
Gym or fitness
Organised sport
Adventure activity
Hired equipment or vehicle
Playground or park
Water activity
Other
Did you sign a waiver?
Select...
Yes
No
Unsure
What happened, and what injuries did you suffer?
Type of professional
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Solicitor
Barrister
Accountant
Financial adviser
Mortgage broker
Builder or engineer
Surveyor
Architect
Other
Brief description of what went wrong
Was it recalled?
Select...
Yes
No
Unsure
Do you still have the product, or a photo of it?
Select...
Yes
No
What happened, and what injuries did you suffer?
Is this about a new or existing class action?
Select...
Existing – already listed
New – not yet listed
Which class action?
Select...
Woolworths & Coles Deceptive Pricing Allegations
Cathay Pacific Flight CX156 Group Action
Health Club Contracts Investigation
Ganges Class Action
Oppressive Contracts Office Equipment Class Action
LATAM Airlines Flight LA800 Group Action
Singapore Airlines Flight SQ321 Group Action
P&O Pacific Aria Cruise Class Action
Private Health Fund Refund Class Action
CTP Insurer Class Action
Harvey Norman Latitude Finance Class Action
Carnival Cruise Ship Gambling
Other / Not listed
What is the issue, and how were you affected?
