Fill out the below information and upload your invoice. A staff member will be in touch. Name of AMIEU member Last name of AMIEU member Member No. (If you have it) Email Address Phone Number Street Address Suburb Post Code Claimants Full Name (If different to the member) Street Address (If different to the member) Suburb Post Code Relationship to member Date of incident Where did the incident occur (home/work) Address if different from above Do you have a health fund or Claim Centrelink? No Yes - Centrelink Yes - Healthfund Did you go to hospital? YesNo If you did not go to hospital, please explain why Please upload your Invoice I hereby declare that the information provided above is true, accurate, and complete to the best of my knowledge and belief. Send Join Online Now
