Claim for Essential Medical Equipment Payment form (SA440)

Use this form if you are claiming for the Essential Medical Equipment Payment (EMEP).

You must download our forms and fill them in so they are processed quickly. You can also electronically sign some of our forms. We have help available if you use assistive technology or need an interpreter.

Download and complete the Essential Medical Equipment Payment Claim form.

Your doctor will need to fill in the Medical practitioners confirmation section in the form before you submit it.

Page last updated: 30 September 2023.
QC 54901