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.

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 - Equipment User Declaration form.

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.

Page last updated: 17 November 2022.
QC 19141