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Equipment Program
Document lists
- Frequently Used Documents
- Document Search
- Program Area
- Assistive Technology Specification Forms
- Selecting Equipment
- Selecting Home Modifications
- Home Modification Templates
-
DHS Equipment Program Documents
- Equipment Program Eligibility Documents
- Prescribing Equipment - by Document Type
- Prescribing Equipment - by Equipment Type
- Prescribing a Home Modification - by Type
- Approvals
- Follow up and Review
- Repairs and Maintenance
- Collections and Returns
- Training
- Equipment Procedures
- Home Modification Procedures
- Recently Updated Documents
Program Area
Documents are listed here according to the relevant program area.
ACTS
Specific Eligibility Criteria Eye Gaze Technology (MS Word Document 161.0 KB)- Specific Eligibility Criteria Speech Generating Devices (MS Word Document 130.5 KB)
- Specific Eligibility Criteria Technology (Computer Access) (MS Word Document 119.5 KB)
- Specific Eligibility Criteria Technology (Environmental Control Systems) (MS Word Document 139.5 KB)
DES
- Bidet Specification and Agreement Form (MS Word Document 375.0 KB)
- Ceiling Hoist Specification and Agreement Form (MS Word Document 145.9 KB)
- Equipment Collection Request (MS Word Document 161.0 KB)
- Information for Provision of Home Modifications (MS Word Document 60.2 KB)
Orientation to DES and the DHS Equipment Program Flyer (PDF 395.4 KB)- ROHO Cell to Seat Size Convert (PDF 514.8 KB)
- Terms and Conditions and Information on Use of Equipment (MS Word Document 86.9 KB)
Equipment Program
- Accessing the Equipment Program step by step guide (MS Word Document 178.8 KB)
- Advanced Palliative Equipment Response Client Registration Form (MS Word Document 94.1 KB)
- Care and Use of a Powered Mobility Aid (MS Word Document 139.5 KB)
- Checklist For Prescribers Submitting Equipment Requests (MS Word Document 165.7 KB)
- Checklist For Prescibers Submitting Home Modification Requests (MS Word Document 168.1 KB)
- Beds checklist’ to Checklist for the Prescription of Electric Beds for APER Clients (MS Word Document 344.2 KB)
- Clinical Considerations for Use of Exercise Pedals (MS Word Document 94.0 KB)
- Completing Clinical Review of Equipment (MS Word Document 446.5 KB)
- Completing Clinical Reviews of Home Modifications (MS Word Document 393.5 KB)
- Completing Follow Up of Equipment (MS Word Document 435.5 KB)
- Completing Follow Up of Home Modifications (MS Word Document 445.0 KB)
- Completing General Review of Equipment (MS Word Document 341.5 KB)
- Completing Powered Mobility Aid Clinical Review (MS Word Document 409.5 KB)
- Consultant and Clinician Roles in Major Home Modifications (MS Word Document 90.0 KB)
- Criteria Screening Tool, Hoist (MS Word Document 62.1 KB)
- Criteria Screening Tool, Electrically Operated Bed (MS Word Document 64.4 KB)
- Criteria Screening Tool, Electric Riser Recliner Chair (MS Word Document 132.0 KB)
- Criteria Screening Tool, Modified Driving Controls (MS Word Document 55.6 KB)
- Criteria Screening Tool, Scooter (MS Word Document 146.5 KB)
- Criteria Screening Tool, Wheelchair Carrier (MS Word Document 64.6 KB)
- Delegate Approval Request Form (MS Word Document 172.7 KB)
- Determining Eligibility for Home Modification (MS Word Document 401.5 KB)
- Equipment Request Form DHS Equipment Program (MS Word Document 149.3 KB)
- Home Modification Request and Agreement Form DHS Equipment Program (MS Word Document 97.2 KB)
- DHS Equipment Program Wig Request Form (MS Word Document 62.8 KB)
- Equipment Program Terms and Conditions of Installation of Home Modifications (MS Word Document 104.3 KB)
- Equipment Request 2023 01 24 (MS Word Document 143.1 KB)
- Equipment Selection Agreement Form (MS Word Document 92.6 KB)
- Equipment Supply Suburb Listing for Metropolitan Adelaide (MS Word Document 172.0 KB)
- Funding of Additional Features to Equipment by Client (MS Word Document 393.0 KB)
- Funding of Additional Home Modification Features by Client (MS Word Document 341.0 KB)
- General Equipment and Home Modification Review (MS Word Document 46.4 KB)
- Generic Specification Form (MS Word Document 116.5 KB)
- Guide to Assessing Pressure Risk Tool (MS Word Document 123.5 KB)
- How Often Do a Client's Powered Mobility Aid Skills Need Review? (MS Word Document 141.0 KB)
- How To Complete the Scooter and Wheelchair Specification Form (MS Word Document 120.0 KB)
- Indicators For Medical Clearance of Powered Mobility Devices (MS Word Document 136.0 KB)
- Major Home Modification Client Information Sheet (MS Word Document 166.1 KB)
- Major Home Modification Satisfactory Completion Agreement Form (MS Word Document 47.1 KB)
- Medical Grade Footwear and Lower Limb Orthoses Request Form 2023 04 04 (MS Word Document 167.4 KB)
- Modifying Equipment Example List. (MS Word Document 93.1 KB)
- Orientation to DES and the DHS Equipment Program Flyer (PDF 395.4 KB)
- Powered Mobility Frequency of Clinical Review Indicators (MS Word Document 145.0 KB)
- Prescribing a Home Modification (MS Word Document 484.0 KB)
- Priority Score Guidelines Adults Equipment (MS Word Document 137.5 KB)
- Priority Scoring Communication and Assistive Technology (MS Word Document 170.8 KB)
- Repair Contingency Plan Highly Customised Equipment (MS Word Document 153.0 KB)
- Requesting Repairs, Maintenance and Replacement of Home Modifications (MS Word Document 328.0 KB)
- Risk Rating and Priority Scoring Form (MS Word Document 126.3 KB)
- Specific Eligibility Criteria Car Hoist (Person Lift Only) (MS Word Document 129.5 KB)
- Specific Eligibility Criteria Ceiling Hoists (MS Word Document 109.5 KB)
- Specific Eligibility Criteria Electric Beds (MS Word Document 100.5 KB)
- Specific Eligibility Criteria Electric Riser Recliner Chairs (MS Word Document 65.2 KB)
- Specific Eligibility Criteria Foot Orthoses and Ankle Foot Orthoses (MS Word Document 173.5 KB)
- Specific Eligibility Criteria Long Ramps (MS Word Document 88.5 KB)
- Specific Eligibility Criteria Major Access Modifications (MS Word Document 82.0 KB)
- Specific Eligibility Criteria Major Bathroom Modifications (MS Word Document 88.5 KB)
- Specific Eligibility Criteria Major Kitchen Modifications (MS Word Document 60.3 KB)
- Specific Eligibility Criteria Major Step Modifications (MS Word Document 86.5 KB)
- Specific Eligibility Criteria Manual Wheelchairs (MS Word Document 113.0 KB)
- Specific Eligibility Criteria Medical Grade Footwear (MS Word Document 114.3 KB)
- Specific Eligibility Criteria Modified Driving Controls (MS Word Document 109.0 KB)
- Specific Eligibility Criteria Posture Chairs (MS Word Document 134.5 KB)
- Specific Eligibility Criteria Provision of a Powered Mobility Aid and a Manual Wheelchair or Non Standard Stroller (MS Word Document 64.2 KB)
- Specific Eligibility Criteria Powered Mobility Aids for Outdoor Use (MS Word Document 144.5 KB)
- Specific Eligibility Criteria Powered Wheelchairs (MS Word Document 156.5 KB)
- Specific Eligibility Criteria Rehabilitation Equipment (MS Word Document 113.5 KB)
- Specific Eligibility Criteria Roof Mounted Wheelchair Carriers (MS Word Document 130.5 KB)
- Specific Eligibility Criteria Speech Generating Devices (MS Word Document 130.5 KB)
- Specific Eligibility Criteria Strollers (MS Word Document 148.5 KB)
- Specific Eligibility Criteria Technology (Computer Access) (MS Word Document 119.5 KB)
- Specific Eligibility Criteria Technology (Environmental Control Systems) (MS Word Document 139.5 KB)
- Specific Eligibility Criteria Towbar Mounted Wheelchair Carriers (MS Word Document 117.5 KB)
- Specific Eligibility Criteria for the Provision of Wigs (MS Word Document 46.6 KB)
- Transferring Ownership of Equipment Items from DHS Terms and Conditions Agreement Form (MS Word Document 53.9 KB)
- Transferring Ownership of Equipment to DHS Terms and Conditions Agreement (MS Word Document 123.0 KB)
- What are Major and Minor Home Modifications (MS Word Document 125.5 KB)
- When does a technician and or specialist need to be accessed (MS Word Document 119.5 KB)
RDNS
- Equipment Request Form RDNS (MS Word Document 146.7 KB)
Last updated:01 Nov 2023 9:03pm
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The Equipment Program website is licensed
under a Creative Commons Attribution 3.0 Australia
Licence. © Copyright 2016