DVA community nursing referral

Your patient is going home, and they’ll need nursing care. They hold a DVA card. You want the handover done right the first time. A DVA community nursing referral is simple once you know the rules. Most hold-ups come from a missing detail, or a referral sent to the wrong place. This checklist covers who can refer, what to include, which form to use and what happens next.

It’s written for GPs, discharge planners, nurse practitioners and practice nurses. It’s also for OTs and social workers, who often spot the need first. Each DVA fact comes from DVA’s own guidance. The main source is DVA’s Notes for Community Nursing Providers, effective November 2025.

Who can refer a DVA client for community nursing?

Four types of health professional can refer a DVA client for community nursing. They are a general practitioner (GP), a treating doctor in hospital, a hospital discharge planner and a nurse practitioner. DVA sets out this list in section 3.2 of its Notes for Community Nursing Providers. Only these four can make the referral.

If you’re a practice nurse, you can help a lot. Gather the details in the checklist below and have them ready for the GP. The referral still comes from the GP.

What if you’re an OT or social worker?

OTs and social workers often see the need for nursing care first. They can’t make the referral on their own. A social worker can refer when they are working as the hospital discharge planner. Otherwise, pass the details to the client’s GP, treating doctor or discharge planner. They then send the referral.

The checklist below makes that handover easy. Share it with the person who will sign the referral. It saves them chasing details later.

Families can’t refer either. If you’re a veteran or a family member, ask your GP about a referral. Our page on who is covered explains what DVA pays for.

What should a DVA community nursing referral include?

A DVA community nursing referral should say who is referring, who the client is, and what care they need. DVA lists the details in section 3.2.1 of its Notes. They include the client’s DVA file number and card type, their clinical details, and a signed medication chart if the nurse will give medicines.

Here’s the list in plain terms:

• About you: your name, your role and your provider number.
• About the client: their name, DVA file number and card type (Gold Card or White Card).
• Condition and clinical details: the diagnosis and the history that matters for the nursing care.
• Care needed: what you’re asking the nurse to do. For example, wound care and dressings, or medication management. Our services page lists all eight types of care we provide.
• Signed medication chart: attach it if medicines are to be given.
• Level of independence: what the client can and can’t do for themselves.
• Other services in place: for example, Veterans’ Home Care (VHC) or Support at Home.
• Aged care assessment status: whether the client has had one.
• Discharge date: if the client is leaving hospital.

If the client holds a White Card, say which condition the care is for. Cover depends on DVA having accepted that condition.

A complete referral lets the provider give you a clear answer sooner. If something’s missing, the provider has to come back to you. That costs time on both sides.

Which form do you use for a DVA community nursing referral?

You can send a DVA community nursing referral in one of three ways. Use DVA’s referral form, D9389. Write it on your own letterhead. Or use the provider’s own referral form. DVA’s Notes allow all three in section 3.2. Choose whichever is quickest for you, as long as it covers the checklist above.

Search “D9389” on the DVA website to get the current version of the form. We don’t have our own form, so send yours to us on DVA form D9389 or your own letterhead. Our referral page shows how.

Where do you send the referral?

Send the referral straight to the community nursing provider. It doesn’t go to DVA first. DVA’s Notes set this out in section 3.2. The provider reads the referral, checks the client’s cover and replies to you. So choose a provider that visits the client’s suburb before you send it.

What happens after you send the referral?

First, the provider decides if it can take the client. If it can’t, DVA says the provider “must immediately notify the referrer verbally and in writing” (section 3.2.6). That way you can refer elsewhere without losing time. If it can, a Registered Nurse assesses the client at home and a care plan is agreed.

Here’s what the steps usually look like:

1. The provider reads the referral and checks the client’s card and cover.
2. You hear yes or no. A yes should come with a plan for the first visit.
3. A Registered Nurse visits the client at home for an assessment.
4. The nurse agrees a care plan with the client. The GP is kept informed.
5. Regular nursing visits begin.

This is how it works with us. Our founders, Sujith and Blessy, are both Registered Nurses. They read referrals, get back to you, and assess new clients at home themselves. We let the GP know what we found after the first visit. As needs change, we update the plan and let the GP know when something needs a doctor.

How is Gold Card and White Card cover checked?

Gold Card holders are covered for community nursing where there’s an assessed clinical need. White Card holders are covered only for a condition DVA has accepted. For a White Card client, the provider checks with DVA before care starts. You don’t need to do this yourself. If DVA covers the care, the client pays nothing. The provider claims from DVA.

That last point matters to families. Many ask about cost first. If DVA covers the care, you can tell them there’s no gap fee. With us, if any care isn’t covered, we’ll tell you before it starts. DVA’s page on community nursing services and providers has more detail.

How long does a DVA community nursing referral last?

A DVA community nursing referral doesn’t last forever. Referrals need renewing from time to time. DVA sets the rules on how long each type of referral lasts, and those rules can change. Check DVA’s current Notes for Community Nursing Providers for the latest periods. You can also ask the provider when a new referral will be due.

What does community nursing not cover?

DVA community nursing covers clinical nursing care and assessed personal care at home. It doesn’t cover cleaning, shopping, transport, respite or companionship visits. Those needs may suit Veterans’ Home Care (VHC). To arrange a VHC assessment, call 1300 550 450. Some clients may get help through Support at Home instead. Our guide to Veterans’ Home Care or nursing compares the programs.

Personal care is worth a closer look. If a client only needs a little help, such as with showering, VHC may suit them better. Community nursing personal care is for clients with an assessed clinical need. If you’re unsure which program fits, list what the client needs on the referral. The provider can talk it through with you.

Your DVA community nursing referral checklist

Use this quick list before you send a referral:

• Are you a GP, a treating doctor in hospital, a discharge planner or a nurse practitioner? If not, pass the details to one of them.
• Your name, role and provider number.
• The client’s name, DVA file number and card type.
• The condition, clinical details and the care needed.
• A signed medication chart, if medicines are to be given.
• The client’s level of independence and the other services in place.
• Their aged care assessment status.
• The discharge date, if they’re leaving hospital.
• Sent straight to the provider, on DVA form D9389 or your own letterhead.

How to send a referral to 3 Star Harmony Solutions

We’re a small community nursing service based in Lalor, in Melbourne’s north. Sujith and Blessy started it. They have about 25 years of nursing experience each. They grew up close to their grandparents. That’s where their respect for older people began.

When you send us a referral, one of them reads it. We’ll let you know if we can take the client. If we can’t, we’ll tell you straight away, so you can refer elsewhere. If we can, a Registered Nurse will assess the client at home, and we’ll keep the GP updated.

Ready to refer? See how to send a referral. Families are welcome to contact us too. We’re happy to explain what to ask the GP for. Our guide to DVA Gold Card nursing at home walks families through leaving hospital.

This is general information. It is current at the date shown at the top of this page. DVA updates its rules from time to time, so check the DVA website for the latest before you refer.