RACQ cyclone mitigation form
Find out if you are eligible for a
cyclone mitigation discount
Please fill out your details below and we will be in touch within 2 business days.
Mandatory fields are marked with *
Text Elements
First Name
*
First Name is required.
Last Name
*
Last Name is required.
Email
*
Please enter a valid email.
Confirm Email
*
Email confirmation must match.
Text Elements
Phone Number
*
Which of the following applies?
*
Please Select
Existing Home/Contents Policy Holder
New Customer
Policy number (if applicable):
Address
*
Suburb
*
Postcode
*
Have you recently installed opening protection?
required.
Have you recently installed roof strapping?
required.
Have you recently installed a roof over-batten system?
required.
Have you recently completed a roof replacement?
required.
I agree to the
terms and conditions
Agree to terms and conditions is required.
*
Fields must be filled in.
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