• Advice to Parent form

  • This form documents the prescribed vehicle 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 car seat 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
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  • 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.
  • Australian standard car seat

    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 Australian standard car seat

    This is an Australian standard car seat 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 car seat

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

  • Harness/vest

    Harnesses and vests (not part of a Australian standard car seat or special purpose car seat) 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:
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