• Advice to Parent form

  • This form documents the prescribed restraint for the child, the review period, and information about installation and use. 

    A separate form will need to be completed if the child is prescribed more than one type of restraint (e.g special purpose child restraint in family vehicle; harness in school bus).

    This form meets the requirements of AS/NZS 4370:2013 Restraint of children with disabilities, or medical conditions, in motor vehicles and best practice. 

  •  -  - Pick a Date
  • Section 1

    Child, parent/guardian and prescriber details
  •  -  - Pick a Date
  • Prescriber 

    AS/NZS 4370:2013 defines a prescriber as:

    “The person or persons responsible for assessing an individual child’s needs and prescribing the way in which a child with a disability or medical condition should be transported in a motor vehicle. For example, occupational therapist, physiotherapist, medical practitioner, rehabilitation engineer.” 

  • Section 2

    Vehicle type and prescribed restraint - if more than one product is prescribed, complete this form for each vehicle.
  • Compliant child restraint

    This type of restraint complies with the Australian/New Zealand Standard 1754 Child restraint systems for use in motor vehicles and meets the legal requirements for use in motor vehicles in all states and territories.

  • Modified compliant child restraint

    This is a compliant child restraint that includes for example, accessories and additional padding, not supplied with the restraint and not included in the manufacturer's instructions. Modifying a child restraint may reduce the child's safety in the event of a crash.

  • Special purpose child restraint

    This type of restraint is designed specifically for children with disabilities and medical conditions. Special purpose child restraints all comply with one or more overseas standards.

  • Harness/vest

    Harnesses and vests (not part of a compliant child restraint or special purpose child restraint) have been designed in response to a range of children's needs. They do not comply with Australian standards.  

  • Modified seatbelt (seatbelt buckle cover)

    Seatbelt buckle covers are an assistive technology device placed over the vehicle seatbelt and may reduce the risk of a child unbuckling. Seatbelt buckle covers do not comply with Australian standards.

  • Section 3

    Important information for the parent/guardian about installing and using the prescribed restraint.
  • Section 4

    Declaration
  • Clear
  • Clear
  • Should be Empty: