An injury can have a big impact on your life and those close to you. We care, and we’re here to support your recovery.
We're here for all businesses in Aotearoa New Zealand. Find out about the levies you pay, cover options, invoicing, and workplace health and safety initiatives.
Find what you need to make working together easy. Learn more about our contracts, invoicing and supporting patient treatment and recovery.
Use this form to request personal information for someone else.
To make sure you have the right to act on behalf of someone else and request their personal information, we need you to complete an authority to act form.
Complete this form to authorise someone to act on your behalf:
Give someone authority to act
Complete this form to authorise someone access to your business levy account:
Give someone access to your levy account
At the completion of this online form, we will be in touch with you to organise you returning this form to us by email.
Enter your details so we can verify your identity. We may contact you if we need more information.
Enter the details of the person you are acting for so we can verify their identity. We may contact you if we need more information.
We may contact you if we need more information about your request.
Your information may include personal and financial details such as bank account information, your Inland Revenue number or medical and other personal information. If we send it to you by post there’s a risk of someone else accessing it through theft, an accident or delivery to the wrong address.
Risks of receiving personal information by courier
Please check your information is correct before submitting
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