JLT Sport / Jardine Lloyd Thompson Pty Ltd / Sportscover Australia / Softball National Risk Protection Programme / Private Health Funds / /
Country
Australia / /
Facility
Club Declaration Non-Medicare / Club Declaration Important Information CLUB DETAILS / Club Declaration Club Contact / Club Declaration Contact Details / Club Declaration No If YES / CLUB DECLARATION / Club Contact Person Position / / /
IndustryTerm
appointed broker / personal accident insurance policy / /
MusicGroup
Yes / What / /
NaturalFeature
WHEELERS HILL / /
Organization
State Softball Association / Private Health Fund / Claimant’s Club / Commonwealth Government / Sportscover Claims Department / Medicare / /
Person
Internal Knee / Do / / /
Position
Injured Person Player Umpire Official / Surgeon Surgeon / Ankle Arm Dental Facial Foot Hand Head / Details PHYSICIAN / Official / Governor / broker / authorised representative / physiotherapist / chiropractor or dentist / Physiotherapist / Report Important Information PHYSICIAN / Physician / Declaration Physician / registered player / Representative / accountant / Trustee / Chiropractor / General Practitioner / Surgeon / assistant Anaesthetist / Physiotherapist / Chiropractor / attending physician / general practitioner / physiotherapist / /
JLT Sport Personal Injury Claim Form Softball National Risk Protection Programme Important Information Important Information