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

Search for a form

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
D9438 Elbow Condition(s) - (MRCA/VEA) Compensation (MRCA/VEA), Compensation, For providers Download as DOCX (68.06 KB)
D9538 Emerging Treatment Psychedelic Assisted Psychotherapy Prior Financial Authorisation MDMA and Psilocybin For providers, Psychiatrist Download as PDF (199.28 KB)
D9521 Employer Incentive Scheme Claim for Reimbursement For providers Download as DOCX (67.04 KB)
D9450 Endocrine Condition(s) - (MRCA/VEA) Compensation (MRCA/VEA), Compensation, For providers Download as DOCX (67.14 KB)
D9450 Endocrine Condition(s) - (MRCA/VEA) Compensation (MRCA/VEA), Compensation, For providers Download as PDF (254 KB)
D9491 Endocrine Disorder(s) - (DRCA) Compensation (DRCA), Compensation, For providers Download as DOCX (70.19 KB)
D9491 Endocrine Disorder(s) - (DRCA) Compensation (DRCA), Compensation, For providers Download as PDF (275.63 KB)
D9400 Essential Medical Equipment Payment (EMEP) claim General, For providers Download as PDF (327.85 KB)
D9384 Exceptional Case Interruption to Care For providers, Registered Nurse Download as PDF (114.19 KB)
D9297 Exceptional Case Unit - Request for Reimbursement of Nursing Consumables over $1,000 For providers Download as PDF (139.46 KB)
D1307 Exceptional Case Variation Registered Nurse, For providers Download as PDF (139.5 KB)
D9470 Eye Condition(s) - (DRCA) Compensation (DRCA), Compensation, For providers Download as PDF (278.03 KB)
D9470 Eye Condition(s) - (DRCA) Compensation (DRCA), Compensation, For providers Download as DOCX (68.19 KB)
D9458 Eye Condition(s) - (MRCA/VEA) Compensation (MRCA/VEA), Compensation, For providers Download as DOCX (63.7 KB)
D9458 Eye Condition(s) - (MRCA/VEA) Compensation (MRCA/VEA), Compensation, For providers Download as PDF (11.75 MB)
D9499 Facial Disfigurement - (DRCA) Compensation (DRCA), Compensation, For providers Download as PDF (11.26 MB)
D9499 Facial Disfigurement - (DRCA) Compensation (DRCA), Compensation, For providers Download as DOCX (63.27 KB)
D9488 Female Reproductive System - (DRCA) Compensation (DRCA), Compensation, For providers Download as PDF (334.64 KB)
D9488 Female Reproductive System - (DRCA) Compensation (DRCA), Compensation, For providers Download as DOCX (74.15 KB)
D9428 Female Reproductive System - (MRCA/VEA) Compensation (MRCA/VEA), Compensation, For providers Download as DOCX (57.69 KB)
D9428 Female Reproductive System - (MRCA/VEA) Compensation (MRCA/VEA), Compensation, For providers Download as PDF (2.97 MB)
D9489 Female Sexual Function - (DRCA) Compensation (DRCA), Compensation, For providers Download as PDF (270.67 KB)
D9489 Female Sexual Function - (DRCA) Compensation (DRCA), Compensation, For providers Download as DOCX (69.76 KB)
D9427 Female Sexual Function - (MRCA/VEA) Compensation (MRCA/VEA), Compensation, For providers Download as PDF (221.46 KB)
D9427 Female Sexual Function - (MRCA/VEA) Compensation (MRCA/VEA), Compensation, For providers Download as DOCX (58.38 KB)