Australian Government - Department of Health - Office of Hearing Services
Hearing Services Program

Forms and publications for professionals

This page includes a range of forms and publications relating to Australian Government Hearing Services Program (the program) for professionals.

Forms for professionals

Request for new voucher when existing has not expired

If a clients' hearing or health changes significantly after they have received the full entitlement of their current voucher (i.e. they have been assessed, received a hearing device and /or rehabilitation), then you are able to request a new voucher before the existing one expires. Please submit the completed request to hearing@health.gov.au

Please note that a request for new voucher when existing voucher has not expired may take up to 15 business days to be processed.
Request for New Voucher when existing Voucher has not yet expired (PDF 76 KB)
Request for New Voucher when existing Voucher has not yet expired (Word 505 KB)

Medical Certificate

Information about the requirements for completing the medical certificate.

Manual Claim for Payment Form

The manual claim for payment form is used when you are unable to make an e-claim or a claim through the portal. 
Manual Claim for Payment fillable form (PDF 116 KB)
Manual Claim for Payment form (Word 58 KB)
Battery and Maintenance Claim for Payment fillable form (PDF 124 KB)
Battery and Maintenance Claim for Payment form (Word 68 KB)

Non-Scheduled Device Request Form

This form is to be used when seeking approval to fit a client with a hearing device that is not listed on the schedule of devices.
Request to Fit a Non-Scheduled Device (PDF)
Request to Fit a Non-Scheduled Device (Word)

Wishes and Needs Tool (WANT)

The Minimum Hearing Loss Threshold (MHLT) is a set of criteria that must be met before fitting or refitting hearing devices. For clients with a 3FAHL of less than or equal to 23dB the Wishes and Needs Tool (WANT) questionnaire should be completed. Service providers should document the information and retain it on the clients file.

Statutory Declaration for Replacing Lost Aids

If the client has lost their hearing device, they will need to complete a statutory declaration form, which must be retained on the clients file. A statutory declaration form and further information is available on the Attorney-General's website.  Further information is available on replacing a lost or damaged device.

Publications for professionals

Eligibility Criteria for Refitting

Service providers should exercise their clinical judgment when making decisions about refitting. Service providers are required to fully document the reasons for refitting and retain this on the clients file. Frequently asked questions have been prepared to assist service providers on the Eligibility Criteria for Refitting.

 




Contacting the Department of Health and other Agencies

Legislation and contracts

For professionals

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