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
D9454 Respiratory Condition(s) - (MRCA/VEA) Compensation (MRCA/VEA), Compensation, For providers Download as PDF (181.01 KB)
D9284 Retraining Questionnaire For providers, Rehabilitation service provider Download as PDF (117.81 KB)
D9545 RPBS Medicinal Cannabis Tier 1 and 2 Authority Prescription Request For providers, General Practitioner, Medical specialist, Specialist (includes all medical specialists in relevant field) Download as PDF (161.62 KB)
D9546 RPBS Medicinal Cannabis Tier 2 Application For providers, General Practitioner, Medical specialist, Specialist (includes all medical specialists in relevant field) Download as PDF (169.25 KB)
D9547 RPBS Unlisted, non-scheduled Authority Prescription request For providers, General Practitioner, Medical specialist, Specialist (includes all medical specialists in relevant field) Download as PDF (131.06 KB)
D0570 Service Pension Claim - Work Test Questionnaire For providers Download as PDF (111.47 KB)
D9481 Shoulder Condition(s) - (DRCA) Compensation (DRCA), Compensation, For providers Download as DOCX (68.13 KB)
D9481 Shoulder Condition(s) - (DRCA) Compensation (DRCA), Compensation, For providers Download as PDF (12.3 MB)
D9439 Shoulder Condition(s) - (MRCA/VEA) Compensation (MRCA/VEA), Compensation, For providers Download as DOCX (69.54 KB)
D9439 Shoulder Condition(s) - (MRCA/VEA) Compensation (MRCA/VEA), Compensation, For providers Download as PDF (242.68 KB)
D9495 Skin Disorder(s) - (DRCA) Compensation (DRCA), Compensation, For providers Download as DOCX (69.44 KB)
D9495 Skin Disorder(s) - (DRCA) Compensation (DRCA), Compensation, For providers Download as PDF (307.87 KB)
D9444 Skin Disorder(s) - (MRCA/VEA) Compensation (MRCA/VEA), Compensation, For providers Download as DOCX (69.47 KB)
D9444 Skin Disorder(s) - (MRCA/VEA) Compensation (MRCA/VEA), Compensation, For providers Download as PDF (219.35 KB)
D9460 Sleep Disorder(s) - (DRCA) Compensation (DRCA), Compensation, For providers Download as DOCX (71.16 KB)
D9460 Sleep Disorder(s) - (DRCA) Compensation (DRCA), Compensation, For providers Download as PDF (341.14 KB)
D0931 Spectacles prescription For providers, Optometrist, Orthoptist and Optical dispenser Download as PDF (204.74 KB)
D9479 Thoraco-lumbar Spine Condition(s) - (DRCA) Compensation (DRCA), Compensation, For providers Download as DOCX (80.02 KB)
D9479 Thoraco-lumbar Spine Condition(s) - (DRCA) Compensation (DRCA), Compensation, For providers Download as PDF (455.53 KB)
D9442 Thoraco-lumbar Spine Function - (MRCA/VEA) Compensation (MRCA/VEA), Compensation, For providers Download as DOCX (69.41 KB)
D9442 Thoraco-lumbar Spine Function - (MRCA/VEA) Compensation (MRCA/VEA), Compensation, For providers Download as PDF (277.22 KB)
TFI01 Tinnitus Functional Index Questionnaire and Scoring Instructions For providers, Audiologist Download as PDF (134.67 KB)
D1328 Treatment prior financial approval request For providers, Chiropractor, Clinical psychologist, Dental prosthetist, Dental specialist, Dentist, Diabetes educator, Dietitian, Exercise physiologist, General Practitioner, Hospitals & day procedure centres, Medical specialist, Neuropsychologist, Occupational therapist (general), Optometrist, Orthoptist and Optical dispenser, Orthotist, Osteopath, Physiotherapist, Podiatrist/Footwear prescriber, Psychologist, Social worker (mental health), Speech pathologist Download as PDF (220.95 KB)
D9447 Upper Gastrointestinal Tract Condition(s) - (MRCA/VEA) Compensation (MRCA/VEA), Compensation, For providers Download as DOCX (71.27 KB)
D9447 Upper Gastrointestinal Tract Condition(s) - (MRCA/VEA) Compensation (MRCA/VEA), Compensation, For providers Download as PDF (283.95 KB)