Request for Revalidated Service proposed changes - Mid July 2024
Overview
This form is to be completed if you wish to request a Revalidated Service for a client with the Australian Government Hearing Services Program.
Supporting Evidence is now required to be submitted with your request. Below is a list of documents you will need to support your request. You will be asked to submit these documents as a combined PDF document or zipped file at Part 4 of the request form.
Required Supporting Evidence
- Audiograms (previous)
- Audiograms (recent)
- Client Review notes or recent client file notes
- Fitting & follow-up notes (where current fitting was not successful or less than 18 months ago)
- Datalogging information (current device usage)
- Recent device optimisation results including REM, REIG etc (Refit requests ECR 1 and ECR 2)
- Supporting letter from the client's Medical Practitioner (refits ECR 2 and ECR 3 requests)
- Speech Discrimination test results - previous and recent (ECR 2 speech discrimination)
- Statutory declaration (if required - lost devices)
- DBR letter, Repair information and quote from the manufacturer for requests resulting from devices with reliability issues.
Schedule of Service Item Program Requirement 46(2): Any Refitting within 12 months of a previous fitting is considered part of the previous Hearing Rehabilitation Program and cannot be claimed. Please consider the success of any recent fitting. Additonal evidence will be required to support your request.
Please click the link below to begin your request.
What happens next
Your requests and supporting evidence will be assessed in a timely manner (within 10 days of submission). An outcome will be sent to to the email address provided in your request.
Audiences
- Contracted Service Providers
Interests
- Hearing
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