THIS SITE IS INTENDED FOR ADVISER USE ONLY

By clicking through to the Investments or Platforms site below you confirm that you are a licensed adviser operating under an Australian Financial Services License.

You may need to access one of the below forms or questionnaires if you have insurance cover through super.

Insurance forms

Form Description

Adviser's report

You will be informed by Colonial First State should you be required to complete this form as part of your insurance application.

Claim for Advanced Life Benefit (Claimant's Statement)

Supply us with information about your employment, condition/illness, medical history and any other information relevant to claiming for an Advanced Life benefit.

Claim for Income Protection (Mental Health Management Report)

You will be informed by Colonial First State should you be required to complete this form as part of your insurance claim.

Claim for Income Protection Disablement Benefit (Claimant’s Initial Statement)

Supply us with information about your employment, condition/illness, medical history and any other information relevant to claiming for Salary Continuance Insurance.

Claim for Income Protection Disablement Benefits (Medical Attendant’s Statement)

Allow your treating physician to provide us with information about your condition/illness for the purposes of claiming for Salary Continuance Insurance.

Claim for Income Protection Progress Certificate (Claimant’s Statement)

You will be informed by Colonial First State should you be required to complete this form as part of your insurance claim.

Claim for Insurance Benefit (Employer’s Statement)

Allow an employer to provide information about your employment.

Claim for Insurance Benefits (Employer’s Statement (Short))

Allow an employer to provide information about your employment.

Claim for Life Insurance Benefit

Make a claim upon the death of the insured member.

Claim for Total and Permanent Disablement Benefit (Claimant’s Initial Statement)

Supply us with information about your employment, condition/illness, medical history and any other information relevant to claiming for Total and Permanent Disablement.

Claim for Total and Permanent Disablement Benefits (Medical Attendant’s Statement)

Allow your treating physician to provide us with information about your condition/illness for the purposes of claiming for Total and Permanent Disablement.

Confidential financial report

You will be informed by Colonial First State should you be required to complete this form as part of your insurance application.

Declaration of health (comprehensive)

You will be informed by Colonial First State should you be required to complete this form as part of your insurance application.

Declaration of health (simple)

You will be informed by Colonial First State should you be required to complete this form as part of your insurance application.

EFT Details for Income Protection Claims

Supply us with EFT payment instructions for your Income Protection claim.

Life events cover:

Personal Super
Employer Super

Increase your cover under a life event option.

Medical examination report

You will be informed by Colonial First State should you be required to complete this form as part of your insurance application.

Insurance Questionnaires

Questionnaire Description

Activities questionnaire and diary

You will be informed by Colonial First State should you be required to complete this form as part of your insurance claim.

Anaemia questionnaire

You will be informed by Colonial First State should you be required to complete this form as part of your insurance application.

Armed forces questionnaire

You will be informed by Colonial First State should you be required to complete this form as part of your insurance application.

Arthritis questionnaire

You will be informed by Colonial First State should you be required to complete this form as part of your insurance application.

Aviation questionnaire

You will be informed by Colonial First State should you be required to complete this form as part of your insurance application.

Asthma, bronchitis or any other lung complaint questionnaire

Complete this form as required when completing the insurance application in the current Product Disclosure Statement.

Bowel disorder questionnaire

You will be informed by Colonial First State should you be required to complete this form as part of your insurance application.

Confidential lifestyle questionnaire

Complete this form as required when completing the insurance application in the current Product Disclosure Statement.

Cysts, moles or skin lesions questionnaire

Complete this form as required when completing the insurance application in the current Product Disclosure Statement.

Declaration of health (simple)

You will be informed by Colonial First State should you be required to complete this form as part of your insurance application.

Diabetes or abnormal blood sugar questionnaire

Complete this form as required when completing the insurance application in the current Product Disclosure Statement.

Drug and Alcohol questionnaire

You will be informed by Colonial First State should you be required to complete this form as part of your insurance application.

Epilepsy questionnaire

You will be informed by Colonial First State should you be required to complete this form as part of your insurance application.

General health questionnaire

You will be informed by Colonial First State should you be required to complete this form as part of your insurance application.

Gout questionnaire

You will be informed by Colonial First State should you be required to complete this form as part of your insurance application.

Headaches/ Migraines questionnaire

You will be informed by Colonial First State should you be required to complete this form as part of your insurance application.

Hearing questionnaire

You will be informed by Colonial First State should you be required to complete this form as part of your insurance application.

High blood pressure questionnaire

You will be informed by Colonial First State should you be required to complete this form as part of your insurance application.

Joint/Musculoskeletal questionnaire

You will be informed by Colonial First State should you be required to complete this form as part of your insurance application.

Mental health questionnaire (client)

Complete this form as required when completing the insurance application in the current Product Disclosure Statement.

Motor sports questionnaire

You will be informed by Colonial First State should you be required to complete this form as part of your insurance application.

Psoriasis questionnaire

You will be informed by Colonial First State should you be required to complete this form as part of your insurance application.

Raised cholesterol questionnaire

You will be informed by Colonial First State should you be required to complete this form as part of your insurance application.

Residency questionnaire

You will be informed by Colonial First State should you be required to complete this form as part of your insurance application.

Self-employed questionnaire

You will be informed by Colonial First State should you be required to complete this form as part of your insurance application.

Sexually transmitted diseases questionnaire

You will be informed by Colonial First State should you be required to complete this form as part of your insurance application.

Sight impairment questionnaire

You will be informed by Colonial First State should you be required to complete this form as part of your insurance application.

Thyroid disorder questionnaire

You will be informed by Colonial First State should you be required to complete this form as part of your insurance application.

Underwater diving questionnaire

You will be informed by Colonial First State should you be required to complete this form as part of your insurance application.

Vocational questionnaire

You will be informed by Colonial First State should you be required to complete this form as part of your insurance application.