Application Detail
Status
ClosedDescription of Medical Service
-Description of Medical Condition
-Reason for Application
-Medical Service Type
-Previous Application Number
Not ApplicableAssociated Documentation
Application Form
-PICO Confirmation
-Assessment Report
Assessment Report (PDF 4087 KB)Appendix F (PDF 1888 KB)
Appendices IJK (PDF 972 KB)
Public Summary Document
One Page Summary (PDF 16 KB)One Page Summary (Word 29 KB)