Essential Medical Equipment Payment - Equipment User Declaration form (SA450)

Use this form to consent to your carer receiving the Essential Medical Equipment Payment instead of you.

This declaration form is part of the claim for Essential Medical Equipment Payment. To claim the Essential Medical Equipment Payment you’ll also need the Essential Medical Equipment Payment – Medical confirmation form.

If you use assistive technology because of a disability or impairment we provide help for assistive technology users of forms.

Page last updated: 27 August 2017