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
D9459 Renal Function - (MRCA/VEA) Compensation (MRCA/VEA), Compensation, For providers Download as PDF (291.15 KB)
D9323 Request for Prior Approval for Dental Implants For providers, Dental prosthetist, Dental specialist, Dentist, Hospitals & day procedure centres, Medical specialist Download as PDF (175.53 KB)
D9469 Respiratory Condition(s) - (DRCA) Compensation (DRCA), Compensation, For providers Download as DOCX (63.75 KB)
D9469 Respiratory Condition(s) - (DRCA) Compensation (DRCA), Compensation, For providers Download as PDF (206.77 KB)
D9454 Respiratory Condition(s) - (MRCA/VEA) Compensation (MRCA/VEA), Compensation, For providers Download as DOCX (68.32 KB)
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 (75.54 KB)
D9481 Shoulder Condition(s) - (DRCA) Compensation (DRCA), Compensation, For providers Download as PDF (385.87 KB)
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)