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Medical Equipment and Aids 23/24

This is a preview of the Medical Equipment and Aids Application form 2022 form. When you’re ready to apply, click Fill Out Now to begin.

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1. Applicant Details(Not Applicable)
2. Equipment details(Not Applicable)
3. Budget(Not Applicable)
4. Certification(Not Applicable)

Applicant Details

* indicates a required field.

Contact Details (Not Applicable)

You must be a permanent GCHHS staff member to apply for funding. Temporary GCHHS staff members must be in their role of employment during the period in which the project is funded.

Name *

First name	Last name

GCHHS ID No. *

Position *

Facility *

Unit *

Department *

Unit Location Equipment to be delivered *

Address line 1

Address line 2

Suburb	State	Postcode

Must be an Australian postcode.

Delivery Instructions *

Ie. Robina loading Dock

Phone *

Must be an Australian phone number.

Must be an email address.

Mobile Phone *

Must be an Australian phone number.