DVA - Regenerative Psychology

Name and DVA file number of the entitled person (as shown on the DVA Health Card)
The treatment entitlement of the person, i.e. Gold Card or White Card (include accepted conditions, if known, for White Card)
Provider name and provider number of the referring health care provider
Confirmation that the referring provider is the entitled person’s usual GP, or a medical specialist or by a health care professional as the result of a hospital discharge
Date of the referral

If the entitled person is resident in a Residential Aged Care Facility (RACF), the level of care that they are funded to receive and the date the funding began
Entitled person’s clinical details (including recent illnesses, injuries and current medication, if applicable)
The condition(s) to be treated or reason(s) for referral (and not the service to be provided e.g. Osteoarthritis of right knee not Rehabilitation)
List other treating health care providers.