Medical Practitioners - Essential Medical Equipment Payment - Medical confirmation form (SA449)

Use this form as part of the assessment for Essential Medical Equipment Payment, to cover the additional costs of running essential medical equipment.

Your Medical Practitioner needs to complete this.

Read the information you need to know about your claim for the Essential Medical Equipment Payment.

This confirmation form is part of the claim for Essential Medical Equipment Payment.

If you have a disability or impairment and use assistive technology, there are other ways you can do your business with us. You can use self service or request someone to deal with us on your behalf. If you can’t access our forms, please contact us. We can help you access, complete and submit them.

Page last updated: 9 July 2018