INFORMATION & FORMS DOWNLOAD
You are here:
Home
Professional Resources
Patient Referral Forms
Click to submit an audiology services referral form for your patients click here
We will contact your patients and organise an appointment as well as inform them of our fees including government funded services, if eligible.
Referral Pads
If you wish to have our referal pads posted to you please click here and submit
OHS Information for Medical Prectitioners
Clients may be eligible for free hearing services provided by the Commonwealth Government’s Office of Hearing Services.
Australian Citizens and permanent residents 21 years of age or older may be eligible to apply for a Hearing Services Voucher if they are:
-
a Pensioner Concession Card Holder
-
receiving Sickness Allowance from Centrelink
-
the holder of a Gold Repatriation Health Card issued for all conditions
-
the holder of a White Repatriation Health Card issued for conditionsthat include hearing loss
-
a dependent of a person in one of the above categories
-
a member of the Australian Defence Force or
-
undergoing an Australian Government funded vocational rehabilitation service and you are referred by your service provider.
The form provided in the link below is for New Applicants only. Part A must be completed and signed by the applicant. Part B must be completed and signed by a Medical Practitioner.
Holders of Repatriation Cards applying for the first time should ask their Local Medical Officer to complete the referral.
The application must be posted to the address provided on the form.
The hearing services voucher will be posted out to the applicant together with a list of Hearing Services Providers within the applicant’s location. The applicant is free to choose which provider they wish to see. We are accredited to provide free to client hearing servives to eligible penioners under the program. For a list of our locations please visit: http://www.hearlink.com.au/contactus.aspx
OHS VOUCHER APPLICATION FORM
Click here to download a voucher application form for your patient, click here
Click here to complete online a voucher application form for your patient, click here
Once completed you would need to print it, as the form needs to be signed by the patient as well as yourself. The completed form should then be posted to the Canberra address shown on the form.
In a few weeks the parient will receive the Hearing Services Voucher, at which point they can contact a hearing services provider of their choice.
Please note we are accredited under the program to provide free hearing services to eligible pensioners.