Enable Application Form

EnableNSW provides assistive technology and services to eligible NSW residents with a chronic medical condition or permanent/long term disability.

Required fields are marked with an asterisk (*).

Please select which program/s you are applying for *
Please select which Home Respiratory Program *

Instructions

  1. Before you start your application, please ensure you have reviewed the checklist and you have all your documents ready to be uploaded. This online form should take you approximately 10-15 minutes to complete and must be completed in one session. You cannot save your application and complete at a later date. If you start your application and close your browser all your information will be lost and you will need to start again.
  2. An application form needs to be completed by the applicant or their representative when requesting assistance from EnableNSW. This form should also be completed when updating details and/or at least every two (2) years. EnableNSW may request an updated form at any time to ensure imformation is current and correct.
  3. In addition to this Application Form, an Equipment Request Form is required and must be completed by an eligible prescriber. The Equipment Request Form provides information regarding the assessment process and reasons for recommendation of the assistive technology
  4. This form provides the applicant's demographic information and details of their medical condition/disability for the purpose of determining eligibility.
  5. Incomplete forms will delay the processing time, please ensure you complete all relevant sections and provide any of the applicable documentation below

Checklist

  • all sections completed
  • copy of Medicare card attached
  • copy of Visa or letter from Immigration (if applicable)
  • copy of Centrelink Pension card attached and/or your partners (if applicable)
  • copy of permanent residency visa (if applicable)
  • copy of Australian Taxation Office assessment notice attached and/or your partners (if applicable)
  • Equipment Request Form completed by an eligible prescriber is also required

Further information or assistance

Telephone: 1800 ENABLE (1800 362 253)
Email: enable@health.nsw.gov.au.