Get Direct Order Form Continence Products

Completing the Direct Order Form for Continence Products online can streamline the process of ordering essential supplies. This guide will provide you with step-by-step instructions to ensure you fill out the form accurately and efficiently.

Follow the steps to successfully complete your order form.

1. Press the ‘Get Form’ button to access the Direct Order Form for Continence Products online.
2. Begin with the prescriber details. Enter the prescriber’s name, select the appropriate title (e.g., Registered Nurse, Urologist), and provide the employer name, date, provider number, phone number, and email address if applicable.
3. In the 'Entitled Person/Delivery Details' section, provide the surname, given names, gender, phone number, customer account number, DVA file number, and card type. Be sure to complete the delivery address and include any necessary delivery instructions.
4. Indicate whether the entitled person lives in a residential aged care facility and whether they receive help under Home Care Package Level 4. Select if the order is additional to an initial order or a result of a new assessment.
5. Complete the order section by referring to the 'Description of Items' overleaf. For each product ordered, enter the supplier item number, DVA item number, description, and quantity. Ensure to limit orders to a maximum of three months' supply as needed.
6. Review all entered information for accuracy. After confirming everything is correct, choose the appropriate action to save changes, download, print, or share the completed form.

Complete your Direct Order Form online to ensure timely delivery of your continence products.