Request personal information for myself

Enter your details so we can verify your identity. We may contact you if we need more information.

If you want a pre-employment report, you'll need to use a different form.

Your first name

Your last name

Previous names known by

Date of birth

Enter your details so we can verify your identity. We may contact you if we need more information.

Your email address

Your current street address

Your phone number

Select the preferred time to receive call (Monday to Friday)

8am - 9am

9am - 10am

10am - 11am

11am - 12pm

12pm - 1pm

1pm - 2pm

2pm - 3pm

3pm - 4pm

4pm - 5pm

What information are you looking for?

ACC claim number (if known)

Add another claim number

Emailed results will be sent in a password protected PDF. We encrypt your information to keep it safe. You’ll need a program that can open 256 bit encrypted PDF files such as Adobe Reader X or newer.
If you select password protected PDF on CD or USB, you’ll need a program that can open 256 bit encrypted PDF files such as Adobe Reader X or newer. We encrypt your information to keep it safe.

Please check your information is correct before submitting.