Services > Statewide > Medical Aids Subsidy Scheme

MASS Application and Information forms

General
Communication Aids
Continence Aids
Mobility and Daily Living Aids
Orthoses and Medical Grade Footwear
Oxygen
Spectacle Supply Scheme

MASS application forms may be completed on the screen, saved (& re-used) then printed out to forward to MASS (or printed out and used as handwritten forms). Refer to the eform user guide for tips on their use.

General

MASS 70 Acquittal Form V0208
MASS 80 Supplier Performance Report V0208
MASS 81 Client Satisfaction Feedback Form V0208
MASS 83 Accident and Incident Report V0208
MASS 84 Concession Card Confirmation Form (Proxy Access to Centrelink Information Form) V0208

Communication Aids

Continence Aids

MASS 50 Continence Aids Application Form V0408
MASS 51 Continence Special Consideration Form V0408
MASS 55 Continence Aids Client Re-Application Form V0408
or use these versions of the MASS 50, MASS 51 or MASS 55 if you prefer to hand write your application forms

Mobility and Daily Living Aids

MASS 20 Mobility and Daily Living Aids Application Form V0408
MASS 20 URGENT Equipment Services Urgent Processing Justification Form V0408
MASS 20 DLA short form V0408 - selected Daily Living Aids only (refer to the user guide)
MASS 20 MWC short form V0408 - SOA Replacement Manual Wheelchair (refer to the user guide)
MASS 20 WWA short form V0408 - SOA Wheeled Walking Aid (refer to the user guide)
MASS 22 Respiratory Drainage Aid Application Form V0408
MASS 23 Bathboard Specification Form V0907
MASS 82 Consent for Photograph/Video Form V0208
Hoist/Sling Compatability Checklist V0408
Home Access and Safety Checklist for Powerdrive wheelchairs V0907
MASS 85 Permanent Loan Information Sheet V0108