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This online form is to be used for all applicants and DCJ tenants wishing to advise of any medical conditions or disabilities that they or their household members have that may impact their housing needs.

Request a Medical Assessment Form Continue your saved form

What you will need

  • Email address
  • Mobile phone number
  • Australian drivers licence, Australian passport or Medicare card
  • Healthcare professional/support provider email and mobile phone number.

What you may need

  • DCJ Client Reference Number, Centrelink  Reference Number or Payment Reference Number

If you have included an assessment request for an additional adult that you are not legal guardian:

  • Additional adult’s email
  • Additional adult’s mobile phone number
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Last updated: 11 Dec 2023