Remote self-exclusion authority and identification form

URL: https://www.publications.qld.gov.au/dataset/5b743aff-7852-41c4-ab03-a83464d6f681/resource/dbeb01f5-03ed-4ea7-864a-dbd871f7cfae/download/remote-self-exclusion-authority-and-identification-form.pdf

Complete this form to authorise the Gambling Help service to act as your representative when consenting to seek a remote self-exclusion from a gaming venue.

Additional Information

Field Value
Data last updated 9 July 2026
Metadata last updated 9 July 2026
Created 26 June 2020
Format PDF
License Creative Commons Attribution 4.0
Has viewsFalse
Iddbeb01f5-03ed-4ea7-864a-dbd871f7cfae
Mimetypeapplication/pdf
Package id5b743aff-7852-41c4-ab03-a83464d6f681
Position12
Size183.1 KiB
Stateactive
Url typeupload