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
D9497 Lower Urinary Tract - (DRCA) Compensation (DRCA), Compensation, For providers Download as DOCX (70.92 KB)
D9497 Lower Urinary Tract - (DRCA) Compensation (DRCA), Compensation, For providers Download as PDF (299.26 KB)
D9477 Lower Limb Function (no joint) - (DRCA) Compensation (DRCA), Compensation, For providers Download as DOCX (74.55 KB)
D9477 Lower Limb Function (no joint) - (DRCA) Compensation (DRCA), Compensation, For providers Download as PDF (368.57 KB)
D9456 Lower Limb Oedema and Vascular Condition(s) - (MRCA/VEA) Compensation (MRCA/VEA), Compensation, For providers Download as DOCX (69.92 KB)
D9456 Lower Limb Oedema and Vascular Condition(s) - (MRCA/VEA) Compensation (MRCA/VEA), Compensation, For providers Download as PDF (193.92 KB)
D9435 Lower Limb(s) Function - (MRCA/VEA) Compensation (MRCA/VEA), Compensation, For providers Download as DOCX (72.13 KB)
D9435 Lower Limb(s) Function - (MRCA/VEA) Compensation (MRCA/VEA), Compensation, For providers Download as PDF (260.4 KB)
D9486 Male Reproductive System - (DRCA) Compensation (DRCA), Compensation, For providers Download as DOCX (75.01 KB)
D9486 Male Reproductive System - (DRCA) Compensation (DRCA), Compensation, For providers Download as PDF (345.93 KB)
D9426 Male Reproductive System - (MRCA/VEA) Compensation (MRCA/VEA), Compensation, For providers Download as DOCX (60.03 KB)
D9426 Male Reproductive System - (MRCA/VEA) Compensation (MRCA/VEA), Compensation, For providers Download as PDF (257.64 KB)
D9487 Male Sexual Function - (DRCA) Compensation (DRCA), Compensation, For providers Download as DOCX (67.24 KB)
D9487 Male Sexual Function - (DRCA) Compensation (DRCA), Compensation, For providers Download as PDF (229.97 KB)
D9425 Male Sexual Function - (MRCA/VEA) Compensation (MRCA/VEA), Compensation, For providers Download as DOCX (1.54 MB)
D9425 Male Sexual Function - (MRCA/VEA) Compensation (MRCA/VEA), Compensation, For providers Download as PDF (232.26 KB)
D9462 Malignant Disorder(s) - (DRCA) Compensation (DRCA), Compensation, For providers Download as DOCX (77.17 KB)
D9462 Malignant Disorder(s) - (DRCA) Compensation (DRCA), Compensation, For providers Download as PDF (493.85 KB)
D9443 Malignant Disorder(s) - (MRCA/VEA) Compensation (MRCA/VEA), Compensation, For providers Download as DOCX (71 KB)
D9443 Malignant Disorder(s) - (MRCA/VEA) Compensation (MRCA/VEA), Compensation, For providers Download as PDF (309.73 KB)
D9490 Mastication and Deglutition - (DRCA) Compensation (DRCA), Compensation, For providers Download as DOCX (69.68 KB)
D9490 Mastication and Deglutition - (DRCA) Compensation (DRCA), Compensation, For providers Download as PDF (279.77 KB)
d9522 Medical Certificate - Capacity for Work and/or Rehabilitation For providers, Medical specialist Download as DOCX (57.34 KB)
D0688 Medical grade footwear (MGF) prescription form For providers, Orthotist, Podiatrist/Footwear prescriber Download as PDF (229.45 KB)
D9292 Medical Imaging Prior Financial Authorisation form For providers, Hospitals & day procedure centres, Imaging and radiology providers Download as PDF (149.18 KB)