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

This form is part of the medical assessment for EMEP. It may help cover extra costs of running essential medical equipment, or heating or cooling in your home.

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.

The Medical confirmation form is not a claim for Essential Medical Equipment Payment.

Download and complete the Medical Practitioners - Essential Medical Equipment Payment - Medical confirmation form.

Your Medical Practitioner needs to complete this form.

Remember, this form is not a claim. You must submit it with your claim for Essential Medical Equipment Payment.

Page last updated: 30 September 2023.
QC 19481