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Departmental form 1567

Status Resolution Support Services Medical Certificate

Help · PDF form · updated 11/03/2025

Important notice: General information only — not immigration assistance or legal advice. For advice about your circumstances, book a verified practitioner.

Compiled from official Department of Home Affairs sources — practitioner verification pending.

What it is for
This form is used to provide medical information to the Department of Home Affairs to support a person seeking assistance for a medical reason under the Status Resolution Support Services (SRSS) Program, helping the department decide how long support may be required.
Who completes it
A treating medical practitioner or health specialist completes the certificate for their patient, who then provides it to their SRSS service provider for submission.
Information it collects (in general terms)
It gathers patient identifying and contact details and clinical information provided by the practitioner, including diagnosed conditions, functional impact, treatment plans, assessed capacity to work, expected duration of incapacity, whether a serious illness category is met, and the practitioner's details and signature.
When it is used
It is used when an SRSS client's medical condition affects their capacity to work and the department needs a practitioner's assessment to inform decisions about the level and duration of support.

This site is not affiliated with the Australian Government. Forms are completed and lodged in your own ImmiAccount; this platform never submits anything to the department.