March Ahead intake & consent form

March Ahead provides two service types: Ongoing Mental Health Treatment (requires a GP referral), and Independent Psychiatric Assessment & DVA Report (one-time assessment using a DVA Report Request/TRN).

You will select your service type in the following section, and only the consent items relevant to your selection will apply. We collect your personal and health information only for assessment, treatment, or preparation of your DVA report. Your information is stored securely and handled in accordance with the Australian Privacy Act 1988.

Information is kept confidential and will only be shared: as required by law (e.g., court subpoena), to prevent a serious and imminent risk, or where you provide written consent (including for correspondence with your GP, treating practitioner, DVA, or your nominated advocate).

I am the veteran completing this form for myselfI am the veteran’s advocate / representative completing this form on their behalf

Advocate Details

I am looking for *

Ongoing Mental Health Treatment (GP Referral Required)Independent Psychiatric Assessment and Report. One-time assessment only with no ongoing treatment (DVA Report Request required)

Initial Liability Claim (ILC) number if you have already lodged a DVA Mental Health Claim

Upload DVA Psychiatric Report Request here, unless already provided

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Upload the GP referral here, unless already provided

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Personal Details

Title *

MrMrsMiss

First name *

Last name *

D.O.B. *

Age

Gender *

MaleFemaleOther

Email address: *

Address *

Street address *

City *

State *

Postcode *

Phone number *

Current occupation/rank *

Emergency contact name *

Emergency contact phone number *

DVA Card Number *

Which service of the Australian Defence Force (ADF) have you served in? *

Royal Australian Navy (RAN)Australian ArmyRoyal Australian Air Force (RAAF)

Details of your Advocate or the Representative, if you have one

I give March Ahead permission to communicate with me via email, acknowledging that email may not be a fully secure method of communication.

*

I consent to a copy of the finalised DVA psychiatric report and related correspondence being shared with my nominated advocate.

Submission date

How did you hear about us?

Signature *

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When you submit this form you will receive an email link to provide further details required for a Comprehensive DVA Report.

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