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Away From Home Haemodialysis (AFHH) Program patient application form

Eligibility criteria

To be eligible for support through the AFHH program, you must meet the following criteria:

  • be a resident of NSW,
  • received haemodialysis treatment for at least three months,
  • be stable on dialysis, with a functional and non-infected fistula or a permanent catheter,
  • received clearance from your treating physician letting us know you are well enough to travel, and,
  • met the receiving dialysis unit’s clinical criteria (assessed in the weeks prior to the scheduled sessions). Each unit will have a different criteria, so be sure to check this as soon as you know your travel plans.
Before you get started, check the eligibility indicator.

When to use this online form

You should use this form if:

  • you have met the eligibility criteria,
  • have contacted the local dialysis unit you are planning on travelling to, and confirmed availability for sessions.

Important information before submitting this request

  • The AFHH program only covers the cost of your dialysis session(s) while you are away from your usual dialysis unit. Any costs outside of a basic dialysis session will not be covered by EnableNSW.
  • This includes:
    • consultations with private physicians,
    • other services you may have received in a private facility such as medications relating to treatment of renal disease,
    • cost associated with your transport, travel and accommodation to and from the dialysis unit, and,
    • nocturnal dialysis that may incur additional cost and hemodiafiltration.

Other important information

  • It is the responsibility of the patient to check with the receiving dialysis unit, the availability of the haemodialysis sessions for the travel dates required. This can be done three (3) months in advance
  • If you require additional session(s) please discuss your request with EnableNSW team before completing this form. Requests will be assessed on a case-by-case basis.
  • Patients with Private Health Insurance which includes cover for Haemodialysis are not covered under the AFHH Program.

Privacy notice

We collect your personal information and the health information of patients to allow EnableNSW to manage and provide its services.

This allows us to:

  • assess your eligibility for AFHH program,
  • contact you if more information is required about the request, as well as provide status updates about the request
  • Contact the nominated external dialysis provider and share your information with them for the purpose of arranging haemodialysis sessions for you

If you would like to view or make changes to your information, please send an email to enable@health.nsw.gov.au or call 1800 ENABLE (1800 362 253) (option 6).

Required fields are marked with an asterisk (*).

Please select request type *

For more information

About EnableNSW

EnableNSW provides assistive technology and related services to people in NSW with specific, short term or ongoing health needs to assist them to live safely at home. Financial assistance is also available for people who need to travel significant distances to access specialist medical treatment which is not available locally.

The EnableNSW team is based in St Leonards and Homebush, New South Wales. Service Centre officers receive thorough, ongoing training to ensure they provide the highest standard of service.

More information

Services provided by EnableNSW Assistive Technology Policy Directive