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DVA Physiotherapy Referral Requirement

A referral is required from a GP, medical specialist or a treating doctor in a hospital to be eligible for physiotherapy services under the DVA scheme.

The referral and can remain active for up to twelve months regardless of the duration specified by the referring practitioner.



The referral must be written on either a DVA Request/Referral Form (Form D904) or official practitioner’s letterhead or referral pad.


All referrals must include:

  1. Name of the veteran to whom the services will be provided
  2. DVA file number of the veteran
  3. Referrer’s provider number
  4. Date of referral
  5. Condition to be treated

The referral must be forwarded to the HIC with your first claim for payment under that referral. Ensure that you also keep a copy for your own records.

Only one referral for eligible veterans to receive physiotherapy services can be active at any one time.



Make an appointment at Physiotherapist Melbourne or call us on (03) 9380 5434.