Request for Revalidated Service proposed changes - Mar 2024

Closes 15 May 2024

Opened 11 Oct 2023

Overview

This form is to be completed if you wish to complete a request for 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 checklist of documents you may be required 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 (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.

 

Audiences

  • Seniors
  • Health professionals
  • Contracted Service Providers
  • Aged care service providers

Interests

  • Hearing