We've already discussed your eligibility for a mobile medical alarm, which could be fully-funded through the Ministry of Social Development ... SO ... let's get your application underway ...
Step One:
Download your MSD "Medical Alarm Assessment Form" ...
Step Two:
Download your MSD "Disability Allowance Application - Medical Form" ...
Step Three:
Print Out one copy of each file you downloaded in Steps 1 and 2 ...
Step Four:
Write your 9-digit MSD "Client Number", your first and last name and date of birth on each form where it says "Client Details or Person Details". (Note: You can find your "Client Number" on the back of your Super Gold Card or your Community Services Card if you have one.) That is all you have to do! Your doctor will complete the rest on both forms.






Step Five:
NOW ... Contact your doctor to discuss whether you need to book an appointment for the review and completion of the forms, or if you can simply drop them off at reception.
You will need to provide your doctor with ...
The "Disability Allowance - Medical Certificate" (Image 1 - containing a total of 2 pages), and your "Disability Allowance - Medical Alarm Assessment Form" (Images 2A & 2B - containing a total of 3 pages). That is a grand total of 5 pages that you will print off & deliver.
Note: Any registered NZ health professional can complete these forms for you. That includes your doctor, any practice nurse or even your dentist if that is easier for you.
Step Six:
Once you've collected the completed forms bring them home with you and keep them safe.
NOW ... Contact me (Brett) on 021 173 9999 (call/txt). If I can't answer, please do leave a voicemail message letting me know that you now have the completed forms. I will call you back to arrange a date to visit and connect your new medical alarm.
During the visit I'll help you with any additional paperwork that may be required for your WINZ application. I've done this for many other clients over the years and I can assure you it is a seamless exercise. Nothing to be anxious about.
That's it! Your part is done! It's not complicated if you follow the simple steps above. I'm always available to help if you find anything confusing. Contact me anytime!
Hello - and Thank You for Taking my Call Today!



