D1327 – Complex Home/Access Modifications
Form ID
D1327
Audience
For providers
Occupational therapist (general)
This form is to be used for the following Rehabilitation Appliances Program (RAP) complex home/access modifications:
- AL05 – Stair Lift
- AL07 – Vertical Platform Lifts
- AL10 – Ramps > 190mm
- AL14 – Step > 2 steps
- AL15 – Bathroom
- AL23 – Stove Isolation Switch
- AL26 – Ramp Demountable
- AL28 – Other Room
- AM04 – Ceiling Hoist
- AZ03 – Shower Seat – Fold Down
- BE01 – Bidet
- BE12 – Bidet RPZ Value
If you are using an Apple computer and want to fill out your form electronically, please download the form and open it with Acrobat 7 or later.
How can I access this form?
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Form file format