Australian Government - Department of Health - Office of Hearing Services
Hearing Services Program

Factsheets and Forms

We have prepared a range of factsheets and forms about the Hearing Services Program (the program) to assist you.

Forms for clients

Medical certificate form

If you are a new client to the program, this form must be completed by your medical practitioner. Once complete please take it to your hearing services provider to finalise your application.

Medical Certificate Form (PDF)
Medical Certificate Form (Word)

Client application form

You can apply for the program online.  In most cases your online application will take a few minutes to complete and you will be told if you are eligible once you have submitted your application.  If you are eligible, you will be sent a welcome pack to the program, and a medical certificate to take to your service provider. 

Apply online today

If you are unable to apply online you can apply by

  • visiting a service provider who can help you apply for the program
  • downloading the paper application form below, to print out and complete

Client Voucher Application Form (PDF)
Client Voucher Application Form (Word)

Reconsideration and appeals form

People who are affected by and dissatisfied with certain decisions made by the program are able to request a reconsideration. A request for reconsideration can only be made in very specific circumstances. You can find more information about reconsideration requests on our website.

Reconsideration and Appeals Form (PDF)
Reconsideration and Appeals Form (Word)

Factsheets about the program

Factsheets regarding eligibility for the program, accessing and providing feedback about services received the program, and more general information can be found in this section.

Factsheets about services available to me through the program

You can read more about the hearing services available through the program in these factsheets.

Factsheets about the hearing devices available through the program

Factsheets relating to the hearing devices available through the program can be found in this section. 


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