Use these forms to arrange treatment and support services for veterans and their dependents who have DVA health cards.

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Most often used

Form ID Form name Who can use this form Updated Download
D0992 D0992 - Mobility Functional Support (MFS) products order form For providers, General Practitioner, Hospitals & day procedure centres, Medical specialist, Occupational therapist (general), Physiotherapist, Rehabilitation service provider, Registered Nurse, Exercise physiologist, Podiatrist, Orthotist, Prosthetist 3 April 2025 Download as PDF (120.17 KB)
D0904 D0904 - DVA request/referral voucher For providers, General Practitioner 3 April 2025 Download as PDF (143.53 KB)
D9132 Dose Administration Aid (DAA) service VSMR For providers, Pharmacist 3 April 2025 Download as PDF (305.76 KB)
D9300 D9300 - Electric Mobility Aids - Part 1 - Medical Assessment For providers, General Practitioner 3 April 2025 Download as PDF (168.96 KB)
D0988 D0988 – Continence direct order form For providers, General Practitioner, Medical specialist, Occupational therapist (general), Occupational therapist (mental health), Physiotherapist, Registered Nurse 3 April 2025 Download as PDF (164.89 KB)

All forms

Form ID Form name Who can use this form Updated Download
D9489 Female Sexual Function - (DRCA) Compensation (DRCA), Compensation, For providers Download as PDF (270.67 KB)
D9466 Fistulae and Hernia Condition(s) - (DRCA) Compensation (DRCA), Compensation, For providers Download as DOCX (68.53 KB)
D9466 Fistulae and Hernia Condition(s) - (DRCA) Compensation (DRCA), Compensation, For providers Download as PDF (242.71 KB)
D9431 Foot and Toe Condition(s) Compensation, For providers Download as DOCX (68.21 KB)
D9431 Foot and Toe Condition(s) Compensation, For providers Download as PDF (284.07 KB)
D9478 Foot and Toe Condition(s) - (DRCA) Compensation (DRCA), Compensation, For providers Download as DOCX (80.5 KB)
D9478 Foot and Toe Condition(s) - (DRCA) Compensation (DRCA), Compensation, For providers Download as PDF (478.01 KB)
D9464 Gastrointestinal Condition(s) - (DRCA) Compensation (DRCA), Compensation, For providers Download as DOCX (70.42 KB)
D9464 Gastrointestinal Condition(s) - (DRCA) Compensation (DRCA), Compensation, For providers Download as PDF (331.95 KB)
D9446 Gastrointestinal Condition(s) Weight and Nutrition Compensation, For providers Download as DOCX (68.74 KB)
D9446 Gastrointestinal Condition(s) Weight and Nutrition Compensation, For providers Download as PDF (232.84 KB)
D9451 Haematological Condition(s) Compensation, For providers Download as DOCX (67.7 KB)
D9451 Haematological Condition(s) Compensation, For providers Download as PDF (232.65 KB)
D9436 Hand & Fingers Condition(s) Compensation, For providers Download as DOCX (68.9 KB)
D9436 Hand & Fingers Condition(s) Compensation, For providers Download as PDF (244.71 KB)
D9484 Hand and Finger Condition(s) - (DRCA) Compensation (DRCA), Compensation, For providers Download as DOCX (78.56 KB)
D9484 Hand and Finger Condition(s) - (DRCA) Compensation (DRCA), Compensation, For providers Download as PDF (11.51 MB)
D9419 Hearing Loss and Tinnitus Compensation, For providers Download as DOCX (1.53 MB)
D9419 Hearing Loss and Tinnitus Compensation, For providers Download as PDF (149.41 KB)
D9473 Hearing Loss and Tinnitus - (DRCA) Compensation (DRCA), Compensation, For providers Download as DOCX (2.12 MB)
D9473 Hearing Loss and Tinnitus - (DRCA) Compensation (DRCA), Compensation, For providers Download as PDF (234.88 KB)
D9445 Hernia and Stoma Compensation, For providers Download as DOCX (67.69 KB)
D9445 Hernia and Stoma Compensation, For providers Download as PDF (206.61 KB)
D9434 Hip Condition(s) Compensation, For providers Download as DOCX (69.07 KB)
D9434 Hip Condition(s) Compensation, For providers Download as PDF (284.25 KB)