Submission Form

Fields marked with an asterisk
(*)
are required.
 

This form should be completed by an eligible person or organisation who wishes to make a submission to the Specialist Medical Review Council (SMRC) for consideration in its review of the contents of a Statement of Principles (SoPs), or a decision made by the RMA not to make a SoPs or (196C(4)) to carry out an investigation.

It is recommended that you read Submission Guidelines before completing this form.

If you would prefer to complete this submission on paper please download the PDF filable/savable version of the Submission Form.

Applicant's details

Address for correspondence

I am making a submission to the SMRC’s review concerning the following RMA decision

Your submission should address the following issues:

Please provide: author's name, date published, publication, page numbers and/or RMA ID Reference Number if known.

Attachments

Attach any documents relevant to your request using the upload options below.

Files must be less than 2 MB.
Allowed file types: rtf pdf doc docx.
Files must be less than 2 MB.
Allowed file types: rtf pdf doc docx.
Files must be less than 2 MB.
Allowed file types: rtf pdf doc docx.
Please provide: author's name, date published, publication, page numbers and/or RMA ID Reference Number if known.
Files must be less than 2 MB.
Allowed file types: rtf pdf doc docx.

Confidentiality

In preparing your submission, please be aware that under 196ZD(1) of  the VEA, the Review Council may make any submissions it receives available to other parties to the review. It may also refer to, or publish, part or all of the contents of submissions in its decision document.

An author of a submission can request that all or part of the submission  should remain confidential.

You could also consider presenting any confidential information in an appendix to the submission to allow the body of the submission to be published.

Files must be less than 2 MB.
Allowed file types: rtf pdf doc docx.