Home/Access Modifications Assessment Form for all Major Modifications

Form ID
For providers
Occupational therapist (general)

Modification to a dwelling (eg bathroom modification, stair lift, ramps, platform steps for walking frames or other modifications).

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)