Request for Ophthalmologist or Optometrist Report form (SA013)

Use this form if you are claiming Age Pension or Disability Support Pension on the basis of permanent blindness.

Download and complete the Request for Ophthalmologist or Optometrist Report.

An ophthalmologist or optometrist must complete this form.

This PDF is fillable. You can fill it out on your device, or print it and complete it by hand.

If you have a disability or impairment and use assistive technology, you may not be able to access our forms. If you can’t, please use self service, request someone to deal with us on your behalf, or contact us. We can help you access, complete and submit them.

Page last updated: 13 July 2021