Ride-on-mower equipment prescription form

Health providers can use this form to request ride-on-mowers and like vehicle equipment for injured employees.


What it contains

This form must be completed for all requests for ride-on-mowers and like vehicles e.g. side-by-side and farm utility vehicles, and related equipment e.g. tow-behind weed sprayers and trailers.

Note: any vehicle used on the Victorian road system that travels for more than two kilometers at a time in one direction is considered to be a motor vehicle. The Transport and Car Needs Assessment Form should be used for the prescription of any motor vehicle.

Supporting evidence must be provided along with the completed form including:

  • measurement recordings
  • detailed site photos showing identified hazards
  • photo and/or video footage of the worker trialing the equipment
  • supporting ADL/home help services assessment
  • all related notes

An equipment trial and site assessment must occur at the injured worker's property.