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Equipment

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Equipment Forms

Equipment Forms

ENABLE NEW ZEALAND EMS EQUIPMENT & MODIFICATION FORMS

ENAE203 - MoH List Equipment
ENAE204 - Complex Equipment

The following two forms must be submitted with the ENAE204 form above.
ENAE205 - Manual Wheelchair Specification
ENAE206 - Power Wheelchair Specification

ENAE207 - Equipment Gifting
ENAE208 - Replacement Equipment

MoH Form - Trial Request
MoH Form - Joint Funding Form

EQUIPMENT INFORMATION

ENAS001 - Equipment Instructions North Island
ENAS002 - Equipment Instructions South Island

MoH Form - Equipment Information
MoH Form - Care and Use of Equipment

MoH Form - Joint Funding Information Sheet

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Phone 0800 17 19 81

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