Independent Medicolegal Referral

Refer a
Medicolegal Matter.

For solicitors, insurers, and case managers. Complete this form to commission an independent OT assessment — functional capacity, care needs, home modifications, or expert witness.

Day standard turnaround

Day urgent available

All

Jurisdictions

Expert

Witness available

Step 1 of 4

Client details

Details about the person being assessed. Fields marked * are required.

Personal information

First name *

Last name *

Date of birth *

Date of incident *

Gender

Contact details

Phone *

Home address *

Interpreter

Is an interpreter required?

Yes

Safety & risk

Select any that apply to inform our assessor before the appointment.

No Risk

Verbal Aggression

Physical Risk

Other

Step 1 of 4

Step 2 of 4

Matter & claim

Tell us about the legal matter and the type of assessment required.

Claim information

Claim type *

Jurisdiction *

Claim / reference number

Court / tribunal (if applicable)

Assessment type required *

Functional Capacity Assessment

Care Needs Assessment

Home Modification Report

Assistive Technology Report

Vocational Assessment

Court Report / Expert Witness

Step 3 of 4

Referring party

Details of the solicitor, insurer, or case manager making this referral.

Referrer details

Your name *

Your role *

Organisation / firm *

Phone *

Email *

Accounts / billing email (if different)

Step 4 of 4

Documents & submit

Upload supporting documents and confirm your declaration before submitting.

Letter of instruction

Upload letter of instruction

PDF or Word — drag and drop, or click to browse

Supporting documents (optional)

Upload other IME reports, medical records, or documents

Multiple files accepted — PDF or Word

Declaration *

I confirm I am authorised to commission this assessment on behalf of the instructing party, and that the information provided is accurate to the best of my knowledge.

I understand that The Empowerment Project will confirm costs and scheduling before the assessment proceeds, and that cancellation fees may apply.

Referral received.

Thank you — we have received your medicolegal referral. Our team will be in touch within one business day to confirm scheduling, costs, and any outstanding documents.

Back to Medicolegal

Prefer to discuss first?

Talk to our
medicolegal team.

Call us to discuss scope, turnaround, or costs before submitting. We are happy to advise on the right assessment type for your matter.

medicolegal@empowerment-project.com.au

Refer aMedicolegal Matter.