Appointing a third party to represent a DVA client

Form ID

Use this form to request a third party (person or organisation) to be permitted to act, enquire and/or receive payments on behalf of a DVA client. Alternatively, you can appoint a representative using DVA’s online claim portal MyService.

If you are using an Apple computer and want to fill out your form electronically, please download the form and open it with Acrobat 7 or later.

How can I access this form?
Form (PDF or Word)