Here is a list of Lifetime Support Authority (LSA) Forms grouped together in alphabetical order by the Application Process, Lifetime Support Scheme (LSS) participant or Service Provider categories.

If you have problems accessing or reading these documents you can ask for a copy to be made available to you in an alternative format.

Email lifetime.support@sa.gov.au to ask for an alternative version of any document on this website.

APPLICATION PROCESS FORMS

• LSA Application Checklist
• LSA Application Form
• LSA Medical Certificate Form
• Burns Assessment Greenwood Scale
• FIM or WeeFIM Assessment Scoresheet

PARTICIPANT FORMS

• Feedback and Complaints online Form
• Reassessment and Disputes online Form
• Consent Form – LSS Participants
• Participant Reimbursement Arrangement Form

SERVICE PROVIDER FORMS

• Home Modification Prescription Form
• Incident Reporting Form
• Medical Information Form: Assessment of Fitness to Drive a Powered Mobility Aid (to be completed prior to all powered mobility aids assessments)
• Prescription form for Standard Equipment
• Prescription form for Customised Equipment
• Repair Contingency Plan for Equipment
• Terms and Conditions of Assistive Technology