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VitalCall is Australia’s
leading provider of 24 hours a day, 7 day a week personal emergency response alarms.

Assessment Form for the supply of a Personal Response System

For queries contact the DVA Health Provider Line: 1300 550 457 (metro) 1800 550 457 (regional) - Option 1

Note:
National Guidelines for the supply of a Personal Response System (PRS) are available on the internet at: http://www.dva.gov.au/providers/provider-programmes/rehabilitation-appliances-program-rap#national-guidelines. Prescribers are advised to take into consideration the criteria listed in the guidelines before prescribing a PRS.

Personal Details

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Warning

VitalCall does not currently provide non-monitored alarms.
Please contact DVA for more information.

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Criteria - Note: The criteria listed below is a summary of the criteria required to be considered prior to prescription of a PRS to be supplied by the Department.

The entitled person should meet one or more of the following criteria prior to the provision of a personal response system

The entitled person must meet all of the following criteria prior to the provision of a personal response system.

If applicable, use this section to expand on any previous sections including important medical conditions, allergies, or other personal details.

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Technical Information

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Prescriber Information

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Emergency Contact Details


Please enter your full address and select from the list below


 


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