Link to Queensland Government (www.qld.gov.au)

Medical Aids Subsidy Scheme

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

All MASS forms now show Cannon Hill contact details any 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. Use the PDF versions if you prefer to hand write your applications, or dont have MSWord.

General

MASS 70 Acquittal Form V0909 - (MASS70 PDF)
MASS 80 Supplier Performance Report V0909 - (MASS80 PDF)
MASS 81 Client Satisfaction Feedback Form V0909 - (MASS81 PDF)
MASS 83 Accident and Incident Report V0909 - (MASS83 PDF)
MASS 84 Concession Card Confirmation Form V1109 - (MASS84 PDF ) (Proxy Access to Centrelink Information Form)

Communication Aids

MASS 21 Communication Aids Application Form V0909 - (MASS21 PDF)
MASS 21 App SGD Speech Generating Device Application Form Appendix V0909 (MASS21SGD PDF )
MASS 21 App AL Artificial Larynx Application Form Appendix V0909 (MASS21AL PDF )
MASS 21 App CS Communication Software Application Form Appendix V0909 (MASS21CS PDF )
MASS 21 App VAD Voice Amplification Device Application Form Appendix V0909 (MASS21VAD PDF)
MASS 86 Communication Aid Information Sheet PDF V0909
MASS 87 Artificial Larynx Care Information Sheet PDF V0909
MASS 88 Voice Amplification Device Care Information Sheet PDF V0909
MASS 88 Speech Generating Device Care Information Sheet PDF V0909
MASS 91 Communication Aids Trial Proforma V0909 (MASS91 PDF )

Continence Aids

MASS 50 Continence Aids Application Form V0909 - ( MASS50 PDF)
MASS 51 Continence Special Consideration Form V0909 - ( MASS51 PDF)
MASS 55 Continence Aids Client Re-Application Form V0909 - ( MASS55 PDF )

Mobility and Daily Living Aids

MASS 20 Mobility and Daily Living Aids Application Form V0909 - (MASS20 PDF )
MASS 20 URGENT Equipment Services Urgent Processing Justification Form V1009 - (MASS20 URGENT PDF )
MASS 20 DLA Short Form V0909 - (MASS20DLA PDF ), selected Daily Living Aids only (refer to the user guide)
MASS 20 MWC Short Form V0909 - (MASS20MWC PDF ), SOA Replacement Manual Wheelchair (refer to the user guide)
MASS 20 WWA Short Form V0909 - (MASS20WWA PDF ), SOA Wheeled Walking Aid (refer to the user guide)
MASS 22 Respiratory Drainage Aid Application Form V0909 - (MASS22 PDF)
MASS 23 Bathboard Specification Form V0909 - (MASS23 PDF)
MASS 82 Consent for Photograph/Video Form V0909 - (MASS82 PDF)
Hoist/Sling Compatability Checklist V0909 - (HOIST/SLING PDF )
Home Access and Safety Checklist for Powerdrive Wheelchairs V0909 - (HOME ACCESS & SAFETY PDF)
MASS 85 Permanent Loan Information Sheet PDF V1009

Orthoses and Medical Grade Footwear

MASS 60 Orthoses and Medical Grade Footwear Application Form V0909 - (MASS60 PDF)
MASS 60 App MGF Medical Grade Footwear Supplier Information Form Appendix PDF V0909
MASS 60 App ORT Orthotist Information Form Appendix PDF V0909

Oxygen

MASS 45 Adult Oxygen Initial and 4 Month Application Form V1109 - (MASS45 PDF)
MASS 45 App Adult Oxygen Information and Safety Form Appendix PDF V0909 -
MASS 46 Adult Oxygen Annual Re-Application Form V0909 - (MASS46 PDF)
MASS 47 Paediatric Oxygen Application Form V0909 - (MASS47 PDF)
MASS 47 App Child Oxygen Information and Safety Form Appendix PDF 0909
MASS 48 Power Failure Emergency Plan V0909 - (MASS48 PDF)
MASS 89 Pendant Oxygen Conserving Device Information Sheet PDF V0909
MASS 90 Pendant Oxygen Conserving Device Trialling Information Sheet PDF V0909

Spectacle Supply Scheme

Last Updated: 11 November 2009
Last Reviewed: 11 November 2009