Get Dhsu

Filling out the Dhsu form is an essential step in requesting medical supplies necessary for individuals enrolled in various support programs. This guide will provide you with clear, step-by-step instructions to complete the form accurately and efficiently.

Follow the steps to effectively complete the Dhsu form.

1. Click ‘Get Form’ button to obtain the form and open it in the editor.
2. In Section 1, enter the client information including surname, given name, middle initial, and birthdate. Be sure to include the address, contact number, and delivery address if it differs from the primary address. Indicate the gender and provide the Personal Health Identification Number (PHIN), along with the date of request and any applicable information for the parent, guardian, or agency.
3. If relevant, move to Section 2 to complete the prescriber information. Here, a regulated health professional will provide their surname, given name, organization, address, fax number, email, and contact number. They must also describe the client’s medical condition, including any diagnoses and recommend the type of supplies needed.
4. In Section 3, list the supplies being requested. Include descriptions of each supply, along with any applicable details such as the MDA SAP number, the quantity per day, and size if required.
5. Use Section 4 to provide any additional information or comments that may be relevant to the request.
6. Once all sections are completed, ensure all provided information is accurate. Save the changes made to the form. You can then choose to download, print, or share the completed form for submission.

Complete the Dhsu form online today to ensure timely processing of your medical supplies request.