Origin Energy Medical Service Request Form



All sections must be completed for appointments to be processed.



Requestor Details



Invoicing



Participant Details


At least one phone number is required


Service Details


(For Field Testing Officers and Bunzl Safety Testing / Manufacturing Positions only)


Participant Availability



Please select at least 9 hours over a minimum of 2 weekdays. If you would like to add additional days to your selection please click on +.

Injurynet will book the participant's medical based on the date and times you have provided. Please note, all cancellations and non-attendances will incur a fee.