Provider Factsheets and Forms

For further information about the Rehabilitation Appliances Program, click on the appropriate link below.

Factsheets

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:

• Providers - RAP - Information for Providers about the Rehabilitation Appliances Program (HIP72) (PDF 118kb)
  
• Information for occupational therapists
  
• Information for providers on home modifications (HIP70) (Adobe PDF 114kB)

Forms

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 
  
  

External Links

• 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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