Whaikaha - Ministry of Disabled People equipment forms

Our forms and guides for EMS equipment assessors and repair technician subcontractors.

Customer

ENAE207 - Equipment Gifting (DOCX, 104 KB)

ENAE212 - Care and Use of Equipment Form (DOCX, 119 KB)

ENAS001 - Equipment Instructions North Island (PDF, 802 KB)

ENAS002 - Equipment Instructions South Island (PDF, 830 KB)

ENAP1002 - Equipment Instructions Palliative Care (PDF, 428 KB)

EMS advice

ENA112 - EMS Advice Request form (PWF) (DOCX, 91 KB)

Wheelchairs

ENAE205 - Manual Wheelchair Specification (DOCX, 85 KB)

ENAE206 - Power Wheelchair Specification (DOCX, 219 KB)

Wheelchair and seating outreach

ENAE211 - Outreach Service Referral and Outcome Summary WMPM (DOCX, 91 KB)

Replacement

ENAE208 - Replacement Equipment (DOCX, 81 KB)

Subcontractors

Enable Equipment Repair Subcontractor Manual (PDF, 1.3 MB)

User notes - Under $500 repair job cards (PDF, 466 KB)

ENAS004 Job Card (DOCX, 765 KB)

ENAS007 - Subcontractor Technician Request Form (DOCX, 53 KB)

ENAS009 - Subcontractor Purchase Order Request (DOCX, 115 KB)

Trials

Supplier trial request form (PDF, 31 KB)

Notices

Whaikaha - Ministry of Disabled People owned equipment for sale (PDF, 220 KB)

Whaikaha/MOE joint funding

Download joint funding forms from the MOH website (updated 31 May 2022)