Provider Factsheets and Forms
For further information about the Rehabilitation Appliances Program, click on the appropriate link below.
The DVA Facts system includes a range of Factsheets, which provide further information about RAP and other DVA programs. Some of the more common ones for providers can be accessed here:
The DVA Forms system is searchable by topic, keyword and form number. These forms apply to the Rehabilitation Appliances Program:
- D0804 - Home Medical Oxygen Therapy Application Form - See also the Guidelines for Prescribing Home Medical Oxygen (Microsoft Word, 190 kb) and the contact details for suppliers
- D0988 - Continence Direct Order Form
— See also the guidelines for prescribing continence products (Adobe PDF, 44 kb) and the contact details for suppliers (Adobe PDF, 25 kb).
- D0992 - Mobility and Functional Support (MFS) Direct Order Form - this form is to be used for requesting items through the Rehabilitation Appliances Program (RAP). For prior approval items, please attach clinical justification or use DVA specified forms.
- D1323 - Authority to Install/Modify Form (Adobe PDF, 136 Kb)
- D1316 - Recliner Chair Assessment Form (Adobe PDF, 225 Kb)
- D1343 Essential Medical Equipment Payment (EMEP) Information Brochure – this brochure should be read before making a claim for the Essential Medical Equipment Payment (EMEP). The EMEP is part of the Household Assistance Package and is an annual payment of $140 to cover the additional costs of running essential medical equipment or medically required heating and/or cooling that arise from the introduction of a carbon price.
- D1342 Essential Medical Equipment Payment - User's Claim Form
- D1340 Essential Medical Equipment Payment - Carer's Claim Form
- D1341 Essential Medical Equipment Medical Confirmation Form – this form is used by medical practitioners to certify requirements as part of a claim for the Essential Medical Equipment Payment.
- D9140 Application for CPAP/Bi-Level Therapy Equipment Form (Adobe PDF, 247 kb) - this form is used by respiratory physicians, cardiologists, physicians and respiratory clinics/sleep centres and has been introduced to streamline the process of requesting CPAP equipment. - See also the Guidelines for Prescribing CPAP (Microsoft Word, 173 kb)
- D9160 Request for Exercise Bike Form (PDF 70kb)
- D9199 - Personal Response System (PRS) Assessment Form (Adobe PDF, 164 kb) - this form is used by occupational therapists and has been introduced to streamline the process of requesting a PRS.
- DVA Rehabilitation Appliances Program (RAP) List of Contracted Suppliers
- The Continence Foundation of Australia (CFA) provides team of continence nurse advisors providing free, confidential advice about bladder and bowel control, plus local referrals, a range of leaflets and product information. A nationwide service for people of all ages with incontinence, their carers, parents and families, clinicians, pharmacists, allied health professionals and the wider community. Australia-wide free call 1800 33 00 66.
- The Thoracic Society of Australia & New Zealand (TSANZ) is the professional society of thoracic physicians, scientists and other health care workers involved in lung disease.
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